Abstract:
Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients
is necessary to anticipate those who require intensive therapy and follow-up. Current literature
shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy
corresponds with decreased survival. However, the value of metabolic parameters has not been
adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of
metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded
tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum
Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement.
HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records
were noted. All patients received stage-specific standard of care therapy. Response assessment on
end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow
involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as
well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to
progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050)
were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017).
This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/
Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma;
however, further studies are required to define the significance of metabolic parameters.
