Prognosis In Stem Cell Transplantation

Autologous stem cell transplantation provides an opportunity for improved long-term survival or cure in many patients with relapsed lymphoma. However, it remains difficult to accurately predict which patients will benefit from this intensive and toxic therapy. Several groups have investigated the potential for FDG-PET performed in the peritrans-plant setting to predict ultimate outcome.41-44 In general, these studies have shown that a negative FDG-PET scan during or after salvage chemotherapy strongly predicts improved PFS after transplant, while those patients with a positive FDG-PET scan prior to transplant are significantly more likely to relapse early. While the data do not definitively rule out the benefit of transplantation for those patients who retain FDG-PET-positive lesions, it may be useful in overall discussions of potential risk and benefit. As more information becomes available regarding this issue, the role of FDG-PET in pretransplantation evaluation will become clearer.

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