Prognostic significance of baseline metabolic tumor volume in relapsed and refractory Hodgkin lymphoma

Alison J. Moskowitz, Heiko Schöder, Somali Gavane, Katie L. Thoren, Martin Fleisher, Joachim Yahalom, Susan J. McCall, Briana R. Cadzin, Stephanie Y. Fox, John Gerecitano, Ravinder Grewal, Paul A. Hamlin, Steven M. Horwitz, Anita Kumar, Matthew Matasar, Andy Ni, Ariela Noy, M. Lia Palomba, Miguel Angel Perales, Carol S. PortlockCraig Sauter, David Straus, Anas Younes, Andrew D. Zelenetz, Craig H. Moskowitz

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Identification of prognostic factors for patients with relapsed/refractory Hodgkin lymphoma (HL) is essential for optimizing therapy with risk-adapted approaches. In our phase 2 study of positron emission tomography (PET)–adapted salvage therapy with brentuximab vedotin (BV) and augmented ifosfamide, carboplatin, and etoposide (augICE), we assessed clinical factors, quantitative PET assessments, and cytokine and chemokine values. Transplant-eligible patients with relapsed/refractory HL received 2 (cohort 1) or 3 (cohort 2) cycles of weekly BV; PET-negative patients (Deauville score £2) proceeded to autologous stem cell transplantation (ASCT) whereas PET-positive patients received augICE before ASCT. Serum cytokine and chemokine levels were measured at baseline and after BV. Metabolic tumor volume (MTV) and total lesion glycolysis were measured at baseline, after BV, and after augICE. Sixty-five patients enrolled (45, cohort 1; 20, cohort 2); 49 (75%) achieved complete response and 64 proceeded to ASCT. Three-year overall survival and event-free survival (EFS) were 95% and 82%, respectively. Factors predictive for EFS by multivariable analysis were baseline MTV (bMTV) (P < .001) and refractory disease (P 5 .003). Low bMTV (<109.5 cm3) and relapsed disease identified a favorable group (3-year EFS, 100%). For patients who received a transplant, bMTV and pre-ASCT PET were independently prognostic; 3-year EFS for pre-ASCT PET-positive patients with low bMTV was 86%. In this phase 2 study of PET-adapted therapy with BV and augICE for relapsed/refractory HL, bMTV and refractory disease were independent prognostic factors for EFS. Furthermore, bMTV improved the predictive power of pre-ASCT PET. Future studies should optimize efficacy and tolerability of salvage therapy by stratifying patients according to risk factors such as bMTV.

Original languageEnglish
Pages (from-to)2196-2203
Number of pages8
Issue number20
StatePublished - 16 Nov 2017


Dive into the research topics of 'Prognostic significance of baseline metabolic tumor volume in relapsed and refractory Hodgkin lymphoma'. Together they form a unique fingerprint.

Cite this