Routine CT Scans for B-cell Lymphoma Patients in Complete Remission Not Recommended

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Routine imaging in patients with diffuse large B-cell lymphoma in first complete remission is not recommended.
Routine imaging in patients with diffuse large B-cell lymphoma in first complete remission is not recommended.

Routine imaging in patients with diffuse large B-cell lymphoma (DLBCL) in first complete remission (CR) is not recommended due to the unlikelihood of relapse, according to an article published in Journal of Clinical Oncology.1

Researchers performed a population-based study comparing the survival of Danish and Swedish patients with DLBCL with different routine imaging. Danish (n=525) and Swedish  patients age 18 to 65 with newly diagnosed DLBCL from 2007 to 2012 and in CR after R-CHOP/CHOEP therapy were included.

Swedish patients' follow-up included symptom assessment, clinical examinations, and blood tests every 3 to 4 months for 2 years.

Imaging was only conducted if relapse was suspected. Follow-up for Danish patients was similar but included computed tomography (CT) scans every 6 months.

RELATED: Histological Transformation Lower for Marginal Zone Than Follicular Lymphoma

An International Prognostic Index (IPI) >2 was found in 25% of Danish patients and 22% of Swedish patients. Patients with an IPI ≤2 had a cumulative 2-year progression rate after CR of 6% (95% CI: 4-9) versus 21% (95% CI: 13-28) in patients with an IPI >2. Age >60 years (HR, 2.3; 95% CI: 1.6-3.4), elevated lactate dehyrdogenase (HR, 2.3; 95% CI: 1.4-3.8), and Eastern Cooperative Oncology Group (ECOG) performance status ≥2 (HR, 1.8; 95% CI: 1.0-3.0) had an unfavorable impact on post-CR survival. Implementing routine imaging did not translate to improved survival in IPI-specific groups or all patients.

Reference

  1. El-Galaly TC, Jakobsen LH, Hutchings M, et al. Routine imaging for diffuse large B-cell lymphoma in first complete remission does not improve post-treatment survival: a Danish-Swedish population-based study [published online ahead of print October 5, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.62.0229

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