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(18)F-fluorodeoxyglucose-positron emission tomography/computed tomography after one cycle of chemotherapy in patients with diffuse large B-cell lymphoma: results of a Nordic/US intergroup study.

https://arctichealth.org/en/permalink/ahliterature272653
Source
Leuk Lymphoma. 2015 Jul;56(7):2005-12
Publication Type
Article
Date
Jul-2015
Author
Karen Juul Mylam
Lale Kostakoglu
Martin Hutchings
Morton Coleman
Dominick Lamonica
Myron S Czuczman
Louis F Diehl
Anne L Nielsen
Paw Jensen
Annika Loft
Helle W Hendel
Victor Iyer
Sirpa Leppä
Sirkku Jyrkkiö
Harald Holte
Mikael Eriksson
Dorte Gillstrøm
Per B Hansen
Marko Seppänen
Karin Hjorthaug
Peter de Nully Brown
Lars M Pedersen
Source
Leuk Lymphoma. 2015 Jul;56(7):2005-12
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Denmark
Female
Finland
Fluorodeoxyglucose F18 - pharmacokinetics
Follow-Up Studies
Humans
Lymphoma, Large B-Cell, Diffuse - drug therapy - mortality - pathology
Male
Middle Aged
Multimodal Imaging
Neoplasm Staging
Norway
Positron-Emission Tomography - methods
Prognosis
Prospective Studies
Radiopharmaceuticals - pharmacokinetics
Survival Rate
Sweden
Tissue Distribution
Tomography, X-Ray Computed - methods
United States
Young Adult
Abstract
We evaluated the predictive value of interim positon emission tomography (I-PET) after one course of chemoimmunotherapy in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). One hundred and twelve patients with DLBCL were enrolled. All patients had PET/computed tomography (CT) scans performed after one course of chemotherapy (PET-1). I-PET scans were categorized according to International Harmonization Project criteria (IHP), Deauville 5-point scale (D 5PS) with scores 1-3 considered negative (D 5PS > 3) and D 5PS with scores 1-4 considered negative (D 5PS = 5). Ratios of tumor maximum standardized uptake value (SUVmax) to liver SUVmax were also analyzed. We found no difference in progression-free survival (PFS) between PET-negative and PET-positive patients according to IHP and D 5PS > 3. The 2-year PFS using D 5PS = 5 was 50.9% in the PET-positive group and 84.8% in the PET-negative group (p = 0.002). A tumor/liver SUVmax cut-off of 3.1 to distinguish D 5PS scores of 4 and 5 provided the best prognostic value. PET after one course of chemotherapy was not able to safely discriminate PET-positive and PET-negative patients in different prognostic groups.
PubMed ID
25330442 View in PubMed
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Cancer mortality does not differ between migrants and Danish-born patients.

https://arctichealth.org/en/permalink/ahliterature260244
Source
Dan Med J. 2014 Jun;61(6):A4848
Publication Type
Article
Date
Jun-2014
Author
Marie Norredam
Maja Olsbjerg
Jørgen H Petersen
Martin Hutchings
Allan Krasnik
Source
Dan Med J. 2014 Jun;61(6):A4848
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - ethnology - mortality
Colorectal Neoplasms - ethnology - mortality
Denmark - epidemiology
Emigrants and Immigrants - statistics & numerical data
Europe, Eastern - ethnology
Female
Genital Neoplasms, Female - ethnology - mortality
Humans
Lung Neoplasms - ethnology - mortality
Male
Middle Aged
Middle East - ethnology
Prospective Studies
Registries
Abstract
The aim of this study was to compare cancer mortality among migrant patients with cancer mortality in Danish-born patients.
This was a historical prospective cohort study. All non-Western migrants (n = 56,273) who were granted a right to residency in Denmark between 1 January 1993 and 31 December 1999 were included and matched 1:4 on age and sex with Danish-born patients. Cancer patients in the cohort were identified through the Danish Cancer Registry and deaths and emigrations through the Central Population Register. Using a Cox regression model, mean sex-specific hazard ratio (HR) for all-cause mortality were estimated by ethnicity; adjusting for age, income, co-morbidity and disease stage.
No significant differences were observed in mortality for gynaecological cancers between migrant women (HR = 1.12; 95% confidence interval (CI): 0.70-1.80) and Danish-born women. Correspondingly, migrant women (HR = 0.76; 95% CI: 0.49-1.17) showed no significant differences in breast cancer mortality compared with Danish-born women. Regarding lung cancer, neither migrant women (HR = 0.79; 95% CI: 0.45-1.40) nor men (HR = 0.73; 95% CI: 0.53-1.14) presented statistical variances in mortality rates compared with Danish-born patients. Similarly, for colorectal cancer, migrant women (HR = 0.64; 95% CI: 0.27-1.55) and men (HR = 1.58; 95% CI: 0.75-3.36) displayed no significant differences compared with Danish-born patients.
Different trends were observed according to cancer type, but cancer mortality did not differ significantly between migrants and Danish-born patients. This may imply that the Danish health-care system provides equity in cancer care.
The study was funded by the University of Copenhagen and Danielsens Fond.
not relevant.
PubMed ID
24947620 View in PubMed
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No survival benefit associated with routine surveillance imaging for Hodgkin lymphoma in first remission: a Danish-Swedish population-based observational study.

https://arctichealth.org/en/permalink/ahliterature275553
Source
Br J Haematol. 2016 Apr;173(2):236-44
Publication Type
Article
Date
Apr-2016
Author
Lasse H Jakobsen
Martin Hutchings
Peter de Nully Brown
Johan Linderoth
Karen J Mylam
Daniel Molin
Hans E Johnsen
Martin Bøgsted
Mats Jerkeman
Tarec C El-Galaly
Source
Br J Haematol. 2016 Apr;173(2):236-44
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Denmark - epidemiology
Diagnostic Imaging - mortality
Disease Progression
Epidemiologic Methods
Female
Hodgkin Disease - drug therapy - mortality - pathology
Humans
Male
Middle Aged
Prognosis
Secondary Prevention - methods
Sweden - epidemiology
Young Adult
Abstract
The use of routine imaging for patients with classical Hodgkin lymphoma (HL) in complete remission (CR) is controversial. In a population-based study, we examined the post-remission survival of Danish and Swedish HL patients for whom follow-up practices were different. Follow-up in Denmark included routine imaging, usually for a minimum of 2 years, whereas clinical follow-up without routine imaging was standard in Sweden. A total of 317 Danish and 454 Swedish comparable HL patients aged 18-65 years, diagnosed in the period 2007-2012 and having achieved CR following ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)/BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) therapy, were included in the study. The cumulative progression rates in the first 2 years were 4% (95% confidence interval [CI] 1-7) for patients with stage I-II disease vs. 12% (95% CI 6-18) for patients with stage III-IV disease. An imaging-based follow-up practice was not associated with a better post-remission survival in general (P = 0·2) or in stage-specific subgroups (P = 0·5 for I-II and P = 0·4 for III-IV). Age =45 years was the only independent adverse prognostic factor for survival. In conclusion, relapse of HL patients with CR is infrequent and systematic use of routine imaging in these patients does not improve post-remission survival. The present study supports clinical follow-up without routine imaging, as encouraged by the recent Lugano classification.
PubMed ID
26846879 View in PubMed
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Outcome prediction by extranodal involvement, IPI, R-IPI, and NCCN-IPI in the PET/CT and rituximab era: A Danish-Canadian study of 443 patients with diffuse-large B-cell lymphoma.

https://arctichealth.org/en/permalink/ahliterature269527
Source
Am J Hematol. 2015 Nov;90(11):1041-6
Publication Type
Article
Date
Nov-2015
Author
Tarec Christoffer El-Galaly
Diego Villa
Musa Alzahrani
Jakob Werner Hansen
Laurie H Sehn
Don Wilson
Peter de Nully Brown
Annika Loft
Victor Iyer
Hans Erik Johnsen
Kerry J Savage
Joseph M Connors
Martin Hutchings
Source
Am J Hematol. 2015 Nov;90(11):1041-6
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Bone Marrow - pathology
Canada
Cyclophosphamide
Denmark
Doxorubicin
Female
Fluorodeoxyglucose F18
Humans
Lymphoma, Large B-Cell, Diffuse - diagnosis - drug therapy - mortality - pathology
Male
Middle Aged
Neoplasm Staging
Ovary - pathology
Pleura - pathology
Positron-Emission Tomography
Prednisone
Prognosis
Retrospective Studies
Survival Analysis
Tomography, X-Ray Computed
Vincristine
Abstract
18F-fluorodeoxyglucose PET/CT (PET/CT) is the current state-of-the-art in the staging of diffuse large B-cell lymphoma (DLBCL) and has a high sensitivity for extranodal involvement. Therefore, reassessment of extranodal involvement and the current prognostic indices in the PET/CT era is warranted. We screened patients with newly diagnosed DLBCL seen at the academic centers of Aalborg, Copenhagen, and British Columbia for eligibility. Patients that had been staged with PET/CT and treated with R-CHOP(-like) 1(st) line treatment were retrospectively included. In total 443 patients met the inclusion criteria. With a median follow-up of 2.4 years, the 3-year overall (OS) and progression-free survival (PFS) were 73% and 69%, respectively. The Ann Arbor classification had no prognostic impact in itself with the exception of stage IV disease (HR 2.14 for PFS, P2 extranodal sites, including HR 7.81 (P?3 sites. Bone/bone marrow involvement was the most commonly involved extranodal site identified by PET/CT (29%) and was associated with an inferior PFS and OS. The IPI, R-IPI, and NCCN-IPI were predictive of PFS and OS, and the two latter could identify a very good prognostic subgroup with 3-year PFS and OS of 100%. PET/CT-ascertained extranodal involvement in DLBCL is common and involvement of >2 extranodal sites is associated with a dismal outcome. The IPI, R-IPI, and NCCN-IPI predict outcome with high accuracy.
PubMed ID
26260224 View in PubMed
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Routine Imaging for Diffuse Large B-Cell Lymphoma in First Complete Remission Does Not Improve Post-Treatment Survival: A Danish-Swedish Population-Based Study.

https://arctichealth.org/en/permalink/ahliterature270756
Source
J Clin Oncol. 2015 Dec 1;33(34):3993-8
Publication Type
Article
Date
Dec-1-2015
Author
Tarec Christoffer El-Galaly
Lasse Hjort Jakobsen
Martin Hutchings
Peter de Nully Brown
Herman Nilsson-Ehle
Elisabeth Székely
Karen Juul Mylam
Viktoria Hjalmar
Hans Erik Johnsen
Martin Bøgsted
Mats Jerkeman
Source
J Clin Oncol. 2015 Dec 1;33(34):3993-8
Date
Dec-1-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Lymphoma, Large B-Cell, Diffuse - drug therapy - epidemiology - mortality - pathology
Male
Middle Aged
Neoplasm Staging
Prognosis
Remission Induction
Survival Rate
Sweden - epidemiology
Tomography, X-Ray Computed - methods
Young Adult
Abstract
Routine imaging for diffuse large B-cell lymphoma (DLBCL) in first complete remission (CR) is controversial and plays a limited role in detecting relapse. This population-based study compared the survival of Danish and Swedish patients with DLBCL for whom traditions for routine imaging have been different.
Patients from the Danish and Swedish lymphoma registries were included according to the following criteria: newly diagnosed DLBCL from 2007 to 2012, age 18 to 65 years, and CR after R-CHOP/CHOEP. Follow-up for Swedish patients included symptom assessment, clinical examinations, and blood tests at 3- to 4-month intervals for 2 years, with longer intervals later in follow-up. Imaging was only recommended when relapse was clinically suspected. Follow-up for Danish patients was similar but included routine imaging (usually computed tomography every 6 months for 2 years).
Danish (n = 525) and Swedish (n = 696) patients with DLBCL had comparable baseline characteristics. Cumulative 2-year progression rate after CR was 6% (95% CI, 4 to 9) for International Prognostic Index (IPI) = 2 versus 21% (95% CI, 13 to 28) for IPI > 2. Age > 60 years (hazard ratio [HR], 2.3; 95% CI, 1.6 to 3.4), elevated lactate dehydrogenase (HR, 2.3; 95% CI, 1.4 to 3.8), B symptoms (HR, 1.7; 95% CI, 1.1 to 2.5), and Eastern Cooperative Oncology Group performance status = 2 (HR, 1.8; 95% CI, 1.0 to 3.0) were associated with worse post-CR survival. Imaging-based follow-up strategy had no impact on survival, neither for all patients nor for IPI-specific subgroups.
DLBCL relapse after first CR is infrequent, and the widespread use of routine imaging in Denmark did not translate into better survival. This favors follow-up without routine imaging and, more generally, a shift of focus from relapse detection to improved survivorship.
Notes
Comment In: J Clin Oncol. 2015 Dec 1;33(34):3983-426438116
PubMed ID
26438115 View in PubMed
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