FDG-PET/CT in Early Assessment of Response to Therapy in Pediatric Hodgkin Lymphoma

Purpose of the study: was to estimate the value of early assessment of response in pediatric Hodgkin lymphoma (PHL) patients using FDG-PET/CT. Methods: prospective analysis of 195 patients presented in Children’s Cancer Hospital, Egypt (CCHE) with pathologically proven untreated PHL, they underwent F-fluorodeoxyglucose positron emission tomography (F-18 FDG PET/CT) early after 2 cycles of chemotherapy (PET 2).This chemotherapy regimen consists of concurrent treatment with Adriamycin, Bleomycin ,Vinblastine & Dacarbazine (ABVD). Analysis of PET 2 was done according to the Deauville score (5-point score) with cut-off 3-4 between Minimal Residual Uptake (MRU) and positive result. Results: Follow-up was done for mean period of 2.9 years (range, 0.6 to 5.2 years).Visual assessment of PET 2 was found to be significantly correlated with Overall Survival (OS) and Progression Free Survival (PFS) in advanced stages PHL (intermediate and high risk patients); the estimate for OS and PFS was 83.3% and 68.8 respectively in the PET-positive (PET +ve) group compared with 97.3% and 92.6|% respectively in the PET-negative (PET – ve) group (p-value <0.0001 and 0.0001). Conclusion: Early assessment of FDGPET/CT after 2 cycles of ABVD in PHL shows potential value in prediction of OS and PFS in advanced stages (intermediate and high risk patients).