Outcome of Diffuse Large B Cell Lymphoma in the United States: Review of SEER Data.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1567-1567
Author(s):  
Rami S. Komrokji ◽  
Najla H. Al Ali ◽  
S.M. Beg ◽  
Jeffrey A. Schrager ◽  
Malek M. Safa
Keyword(s):  
United States ◽  
Early Stage ◽  
B Cell Lymphoma ◽  
The United States ◽  
Rank Test ◽  
P Value ◽  
Advanced Stage ◽  
Log Rank Test ◽  
Black Patients ◽  
Seer Data

Abstract Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Outcome data of DLBCL among a large population in the United States outside the context of clinical trials has not been reported. We examined survival trends of DLBCL patients among a large population based registry in the last four decades. Method: Surveillance, Epidemiology, and End Results (SEER) histology codes 9680, 9684, 9697 were used to identify all cases of DLBCL between 1973 and 2004. Kaplan-Meier estimates were used for median overall survival (OS). Variables analyzed included age, race, sex, stage, and year of diagnosis. SPSS statistical software was used for analysis. Results: Between 1973 and 2004, 59728 cases of DLBCL were recorded in the SEER data. The mean age of diagnosis was 63 years. 32505 (54.4%) were male and 27223 (45.6%) were female. The majority of patients, 51795 (86.7%), were white, 3733 (6.3%) were black, and 4200 (7%) were other races. Staging information was available in 57% of the cases, 18091 (30%) were early stage (I, II), 15862 (27%) were advanced stage (III, IV) and in 25775 (43%) the stage was unknown/missing. The overall median survival was 25 months. The 5 year OS was 36%. The relative 5 year OS was 47%. The median OS for females was 28 months compared to 21 months for males (log rank test, P value < 0.005). The median OS for white patients was 25 months compared to 16 months for black patients (log rank test, P value <0.005). The median OS improved over time. Specifically, for patients diagnosed between 1973–1979, 1980–1989,1990–1999, and 2000–2004 the median OS was 15, 18, 20, and 47 months, respectively (p value <0.005) (see Figure). The improvement in median OS was seen among both sexes, all ages and races. Also, the improvement in OS was seen in both early and advanced stages. For the period 2000–2004, 24,303 patients were identified. Of these 57% were males, 86% were white and 7% were black. Fifty percent were early stage and 44% were advanced stage; the stage was unknown in 6%. The median OS was 47 months. The 4 year overall survival was 46%. The median OS for early stage was not reached and was 19 months for patients with advanced stage (log rank test, p value <0.005). Outcome was better in white patients compared to black patients: 47 months compared to 29 months, respectively (log rank test, p value 0.001). No differences between males and females were noted. The median OS for patients <60 years old was not reached compared to 23 months for patients over the age of 60. In a Cox regression model all variables analyzed (age, sex, race, stage and year of diagnosis by decade) were statistically significant independent factors. Conclusion: This is the first report on outcome of DLBCL in the SEER data. The outcome of DLBCL in the United States has improved significantly in the era of monoclonal antibodies. Black patients had inferior outcome. No sex differences in outcome are noted in the recent years. The SEER data analysis has several limitations namely lack of accurate staging information, IPI scoring and treatment details. Figure Figure

Improvement in Follicular Non Hodgkin Lymphoma Survival among VA Patients.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4423-4423
Author(s):  
Shaili Desai ◽  
Malek M. Safa ◽  
Rami S. Komrokji
Keyword(s):  
Hodgkin Lymphoma ◽  
Early Stage ◽  
Rank Test ◽  
P Value ◽  
Racial Groups ◽  
Advanced Stage ◽  
Cancer Data ◽  
Non Hodgkin Lymphoma ◽  
Black Patients ◽  
New Treatments

Abstract Background: Follicular non Hodgkin lymphoma (FL) remains uncurable disease for majority of patients. Natural history of follicular lymphoma is changing with inroduction of new treatments. We examined outcome of FL among VA patients in the era of monoclonal antibodies. Methods: This was a retrospective analysis. The VA Central Cancer Registry (VACCR) database was used to identify patients with FL diagnosed between 1995 and 2005. There are approximately 120 VA medical centers diagnosing and/or treating patients with cancer. Data were analyzed using bio-statistical software SPSS. Variables included age, sex, stage of disease, histology subtype, date of diagnosis, date of last contact, vital status. Results: There were1338 patients with FL at the VACCR database between 1995 and 2005, 283 (88%) were white, 128 (10%) black patients, and 39 (2%) patients from other racial groups. The mean age at diagnosis was to 64 years. Four hundred twelve (31%) were grade I FL, 312 (23%) Grade II, 215 (16%) Grade III, and 399 (30%) FL, NOS. Four hundred twelve (30%) patients were early stage (I,II), 600 (45%) were advanced stage (III,IV) and 331 (25%) missing or unkown. No FLIPI score data were available. Median overall survival (OS) was 7 years. The median OS for early stage was 8.6 years compared to 5.5 years for advanced stage. The median OS for patients diagnosed 1995–2000 was 5.9 years compared to 9.7 years for patients diagnosed between 2001–2005. (log rank test, P value 0.025). The two groups were balanced regarding stage, race and chemotherapy. Conclusions: The survival of FL patients has improved in the VA system in the era of rituximab. Figure Figure

T-cell clonality in peripheral blood as a predictor of progression to systemic treatment in patients with stage IB mycosis fungoides (MF).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19538-e19538
Author(s):  
Suravi Raychaudhuri ◽  
Charli-Joseph Yann ◽  
Michelle Mintz ◽  
Laura Pincus ◽  
Chiung-Yu Huang ◽  
...  
Keyword(s):  
T Cell ◽  
Peripheral Blood ◽  
Systemic Treatment ◽  
Rank Test ◽  
P Value ◽  
Advanced Stage ◽  
Stage Ib ◽  
Log Rank Test ◽  
Secondary Outcomes

e19538 Background: A major unmet clinical need in the care of early-stage MF patients is the identification of those with a high risk of failing skin directed therapy or progressing to advanced disease. Herein, we inquired if the identification of a clonal T-cell receptor (TCR) gene rearrangement by PCR in peripheral blood could predict the clinical outcome, particularly the need for systemic treatment, in patients with stage IB MF. Methods: This is a retrospective cohort study of patients with stage IB MF who underwent peripheral blood TCR clonality analysis by PCR. The primary outcome of the study was time from diagnosis to initiation of systemic treatment. Secondary outcomes were: (1) time to progression to advanced-stage disease (stages IIB-IV) and (2) overall survival. Patients were censored at time of last clinical follow up. Log rank test was used to compare the survival distributions of the two groups; p value < 0.05 was considered significant. Results: From May 2014 to October 2019, 56 consecutive stage IB pts with > 6 months follow up were included in this analysis. Peripheral blood TCR clonality status was available in 42 patients: 18 pts had a positive TCR clone and 24 did not. Median follow up time was 36 months (range 8.5 – 198 months). At 3 years, 39% of patients with peripheral clone had progressed to systemic treatment versus 8% of those without a peripheral clone (log rank test, p-value = 0.003). For the secondary outcomes, at 3 years 17% of patients with peripheral clone had progressed to advanced stage versus 4% of those without (log rank test, p-value = 0.10); 5% of patients with peripheral clone had died versus 0% of those without (log rank test, p-value = 0.03). Conclusions: Detection of a predominant TCR clone by PCR in the peripheral blood is an important prognostic marker in the initial workup of MF, as its presence is highly correlated with subsequent progression to systemic treatment and death. If this finding is validated, it can be used to risk stratify and individualize therapy for MF patients.[Table: see text]

Differences in Cell of Origin (COO) Affect Outcomes in Caucasian(C) but Not in African American(AA) Patients with Diffuse Large B-Cell Lymphoma(DLBCL)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1460-1460 ◽  
Author(s):  
Uma Borate ◽  
Deniz Peker ◽  
James M. Foran ◽  
Luciano J Costa
Keyword(s):  
B Cell ◽  
B Cell Lymphoma ◽  
Disease Stage ◽  
Rank Test ◽  
Advanced Stage ◽  
Cell Of Origin ◽  
First Line ◽  
First Line Therapy ◽  
Log Rank Test ◽  
Line Therapy

Abstract Introduction: DLBCL is an aggressive mature B-cell neoplasm with a low incidence in African Americans and other minority groups. The differences in outcomes based on DLBCL Cell of Origin(COO) immunophenotypic subtypes as defined by the Hans algorithm using CD10, Bcl-6, and MUM1 namely germinal center B-cell (GCB) and non-GCB have been based on predominantly Caucasian patients (pts) and their impact on outcomes in AA patients have not been well studied. Material and Methods: A retrospective review of clinicopathologic data from patients diagnosed and treated for DLBCL at UAB between 2002-2011 was conducted following IRB approval .The data collected included patient demographics (age, sex, self identified race), DLBCL subtype (GCB vs. non-GCB based on the Hans algorithm), disease stage, first line therapy regimens and patient outcomes. We analyzed group differences in both C and AA pts with GCB and non-GCB subtypes of DLBCL in all the parameters mentioned above using the chi square test for categorical variables,. In addition, OS was examined using Kaplan Meier curves and the log rank test. We performed univariate and multivariate analyses to examine the effects of variables of interest on OS. All results were considered statistically significant at α=0.05 level. Results: We included a total of 259 pts in our analysis after excluding patients with missing demographics, disease related data, primary mediastianal DLBCL, missing first line therapy data and outcomes data as well as race identified as other than C or AA. 45 patients (17.4%) of patients self identified as AA and 214 (82.6%) self identified as Caucasian. The mean age of presentation for AA pts was 52 yrs compared to 58 years for C patients (p=0.045) and 28 (62.2%) AA patients presented with advanced Stage III and IV disease compared to 89 (44.6%) of C patients (P=0.04) both being statistically significant. Based on COO characterization using immunophenotype by Hans algorithm, 27 AA pts (60%) and 145(67%) of C pts were GCB by immunophenotype(p=0.317). 95% of all patients received R-CHOP as first line therapy , 3.5% received R-CVP and the remaining received a combination of Rituximab alone, FCR or radiation therapy .On analyzing OS based on COO, AA patients did not demonstrate a significant difference in OS based on COO with both GCB and non-GCB groups having a median OS of 84 months ( p=0.74)( 95% CI 72-121 months). However, the median OS for C pts with GCB phenotype was 104 months compared to 25 months for the non-GCB phenotype and the median OS was 55 months +/-12.6 months for the C pt group as a whole( p<0.001 by log rank test )which was highly statistically significant.Multivariate analyses of different factors affecting OS showed only COO (p<0.001), age(p=0.07) and stage of DLBCL at presentation(p=0.027) to affect OS significantly.Race,Gender and IPI score did not appear to impact OS significantly. Conclusion: Our study aimed to study the impact of COO and Race on OS in DLBCL especially in AA pts where this has not been well characterized. Our results show that as expected the incidence of DLBCL is lower in AA patients compared to C pts. However, DLBCL presents at younger age and with more advanced stage in AA than in C patients. Although distribution of COO is similar in AA and C patients, our findings suggest that COO may not have the same effect on prognosis among AA pts as it does among the C pt population where we see non-GCB patients do significantly worse than their GCB counterparts. This may reflect a different disease biology in AA patients that has yet to be understood. Our study limitations include not taking into account disease relapse, second line therapy and effect of autologous bone marrow transplantation on overall survival. Figure 1. Figure 1. Figure 2. Figure 2. Figure 3. Figure 3. Disclosures No relevant conflicts of interest to declare.

Impact of colonoscopy on patients older than 75.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15096-e15096
Author(s):  
Dhauna Karam ◽  
Mohammed Al-Hamadani ◽  
Shah Pallavi ◽  
Mohamed Shanshal ◽  
Janos Molnar
Keyword(s):  
United States ◽  
Overall Survival ◽  
Survival Time ◽  
The United States ◽  
Young Age ◽  
Screening Colonoscopy ◽  
Rank Test ◽  
P Value ◽  
Age Group ◽  
Mean Survival Time

e15096 Background: Colorectal cancer is the second leading cause of cancer related deaths in the United States. As per current screening guidelines, screening should begin by age 50 and be continued till age 75. Routine screening over 75 years is not recommended. Methods: Our primary objective was to compare survival time in patients undergoing colonoscopy aged 75 years or older to those aged 50-74. The study was conducted at Captain James A. Lovell Federal Health Care Center (FHCC), North Chicago, United States between 2002 and 2012. A retrospective chart review was performed for patients who underwent colonoscopy. Mortality in terms of survival time was compared between patients equal or older than 75 versus those aged 50-74 years with similar procedural indications and life expectancy of 5 years or more. Survival analysis was performed via Kaplan Meier curve with log-rank test. Results: A total of 213 patients were included in the study . Fifty one percent of the patients (108) were 50-74 years old (young age group), while 49% (105) were 75 or older (old age group). Patients had colonoscopy done for following indications: 92 (43%) screening colonoscopy, 62 (29.1%) diagnostic colonoscopy and 59 (27.7%) surveillance colonoscopy. There was no statistical difference between the age groups based on indication of colonoscopy (P = 0.899). Overall mean survival time for all patients was 123.6 months (10.3 years). Survival time was significantly higher for young age group with a mean overall survival of 131.1 months (10.9 years). Older age group had a mean overall survival time of 106.9 months (8.9 years). P-value = 0.009. The highest overall mean survival time was observed in patients who were under 75 and had colonoscopy for screening purposes 138.9 months (11.6 years) (P = 0.019). The lowest overall mean survival time was seen in those who were > 75 years and had colonoscopy due to diagnostic purposes 93.6 months(7.8 years). (P = 0.055) Conclusions: Although statistically significant higher survival time was noted in patients younger than 75, older patients also had a survival time of more than 7 years. This will impact the decision to offer screening colonoscopy to older people who will definitely benefit from the test.

Poor Predictive Value of FDG-PET/CT Performed after 2 Cycles of R-CHOP in Patients with Diffuse Large B-Cell Lymphoma (DLCL)

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 371-371 ◽  
Author(s):  
Amanda Cashen ◽  
Farrokh Dehdashti ◽  
Jingqin Luo ◽  
Nancy L. Bartlett
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
B Cell Lymphoma ◽  
Response Criteria ◽  
Rank Test ◽  
P Value ◽  
Log Rank Test ◽  
Medical Oncologists ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: In patients with aggressive NHL, whole-body positron emission tomography/computed tomography (PET/CT) with [18F]fluorodeoxyglucose (FDG) performed after 2–4 cycles of front-line therapy has a reported positive predictive value (PPV) of 80–100% and a negative predictive value (NPV) of 70–100%. However, the studies reporting these results were primarily retrospective, contained a mixture of NHL subtypes and therapies, and did not apply the recently published consensus response criteria (J Clin Oncol2007; 25:579). In addition, the interpretation of PET reports as positive or negative is often difficult for the treating oncologist. Methods: In this study, patients with a new diagnosis of advanced stage diffuse large B-cell lymphoma (DLCL) received standard R-CHOP × 6 cycles. Patients had FDG-PET/CT scans performed after cycle 2 or 3 and at the completion of therapy. Two medical oncologists (AC, NB) reviewed the FDG-PET/CT reports and interpreted them as positive, negative, or equivocal. A nuclear medicine radiologist (FD) then reviewed the scans and applied the consensus response criteria to score each FDG-PET/CT as positive or negative. All patients provided written informed consent. Results: Fifty patients (mean age 58 years, range 29–80) with stage III (n=15) or IV (n=35) DLCL were enrolled between March 2005 and May 2008 and treated with R-CHOP. All patients had a FDG-PET/CT performed after cycle 2 (n=47) or 3 (n=3), and 42 patients had FDG-PET/CT after 6 cycles. Median follow-up is 15 months. The medical oncologists interpreted the post-cycle 2 FDG-PET/CT reports as follows: 15 (30%) positive, 15 (30%) negative, 20 (40%) equivocal. Their NPV was 87% and the PPV was 27%. Patients with equivocal scans had outcomes similar to those with negative scans (80% free of relapse). After the radiologist’s review, the equivocal scans were classified as negative (n=10, 50%) or positive (n=10, 50%). The reviewed post-cycle 2 PET/CT results did not significantly correlate with progression-free survival (PFS) (graph, log-rank test p-value=0.35), and NPV and PPV were 85% and 25%, respectively. At the completion of therapy, the medical oncologists called 5 (12%) FDG-PET/CT reports positive, 25 (60%) negative, and 12 (29%) equivocal. These results significantly correlated with PFS (logrank test p-value&lt;0.001; NPV 92% and PPV 80%). Again, the equivocal scans predicted outcomes similar to negative scans (92% free of relapse). The final, radiologist-reviewed FDG-PET/CT results were also significantly associated with outcome (graph, log-rank test p-value&lt;0.001). Conclusions: In contrast to prior reports on the value of interim FDG-PET/CT, our results demonstrate that in DLCL patients treated with R-CHOP who are assessed prospectively, interim FDG-PET/CT does not predict PFS. However, end of therapy FDG-PET/CT does correlate strongly with PFS. It may be that the dichotomous consensus response criteria, which apply to end of therapy FDG-PET/CT, are not useful for interpretation of interim scans. In support of a more relative interpretation of interim FDG-PET/CT, we found that the subset of FDG-PET/CT reports that cannot be clearly designated as positive or negative predict outcomes similar to those of negative scans. Figure Figure

Unstaged Diffuse Large B Cell Lymphoma in the United States: Predictors and Patient Outcomes

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2109-2109
Author(s):  
Binay K. Shah ◽  
Amir Bista ◽  
Sandhya Sharma
Keyword(s):  
United States ◽  
B Cell ◽  
Household Income ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
The United States ◽  
P Value ◽  
Factors Associated ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background: Treatment and prognosis of diffuse large B cell lymphoma (DLBCL) depends on the stage of lymphoma. We conducted this study to examine unstaged DLBCL in the United States. Methods and methodology: We used Surveillance Epidemiology and End Result (SEER) 18 registries to select patients with DLBCL diagnosed during January 2000 to December 2012. We used LRD Summary stage 2000 was used to determine stage of the disease - localized, regional, distant or unstaged. We used Logistic regression to investigate factors associated with unstaged DLBCL. We used Cox Proportional Hazard model to compare survival outcomes. Results: Among 67765 patients, 3194 (4.71%) were unstaged. Age (60+years), "Others" and Caucasian races, single or single/divorced/widow marital status, metropolitan residence, median household income> $50,000, lymph node as the primary site and cased with other primaries before diagnosis of DLBCL were the factors associated with unstaged cases (Table 1). The 5- year relative survival rate for unstaged patients was inferior to those with localized and regional disease, and superior to those with distant disease (HRs of 0.58, 0.66 and 1.24 for localized, regional and distant respectively when compared to unstaged cases). Conclusion: In this large population-based study, 4.71% patients with DLBCL had unstaged disease. Patients with unstaged DLBC had significantly inferior survival rates compared to patients with localized and regional stage. Table 1. Factors associated with unstaged DLBCL cases Parameters Unadjusted OR (95% CI) P value Adjusted OR (95% CI) P value Age (60+ Vs. <60 years) 1.478 (1.363 - 1.602) <0.001 1.458 (1.335 - 1.592) <0.001 Sex (Female Vs. Male) 1.063 (0.990 - 1.141) 0.093 0.983 (0.911 - 1.059) 0.646 Race Caucasians Reference Reference African American 0.804 (0.691 - 0.935) 0.005 0.835 (0.715 - 0.974) 0.022 Others 1.109 (0.976 - 1.261) 0.112 1.257 (1.104 - 1.431) 0.001 Marital Status Married Reference Reference Single 1.026 (0.927 - 1.135) 0.662 1.208 (1.086 - 1.345) 0.001 Single/divorced/widow 1.249 (1.152 - 1.355) <0.001 1.185 (1.087 - 1.291) <0.001 Rural/Urban Rural Reference Reference Urban 0.878 (0.651 - 1.183) 0.393 0.896 (0.661 - 1.214) 0.479 Metropolitan 0.882 (0.667 - 1.165) 0.882 1.028 (0.767 - 1.379) 0.852 Median annual household income Upto 25,000 Reference Reference >25,000-50,000 01.009 (0.753 - 1.354) 0.951 0.927 (0.675 - 1.271) 0.636 >50,000 0.758 (0.563 - 1.021) 0.068 0.673 (0.486 - 0.933) 0.017 Sequence (Not first or only primary vs. first or only primary) 1.261 (1.156 - 1.377) <0.001 1.219 (1.115 - 1.334) <0.001 Site of primary Lymph nodes Reference Reference Extra-lymphatic 0.760 (0.704 - 0.821) <0.001 0.748 (0.693 - 0.808) <0.001 Unknown primary 6.295 (4.569 - 8.672) <0.001 6.727 (4.865 - 9.300) <0.001 Disclosures No relevant conflicts of interest to declare.

Allogeneic Stem Cell Transplantation for Patients with Chemo-Refractory or Progressive Aggressive Non-Hodgkin’s Lymphomas.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3265-3265
Author(s):  
Mehdi Hamadani ◽  
Kristie A. Blum ◽  
Patrick Elder ◽  
Thomas S Lin ◽  
Pierluigi Porcu ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Rank Test ◽  
P Value ◽  
Log Rank Test ◽  
Significant Difference ◽  
Hodgkin's Lymphomas

Abstract Background: Patients (pts) with chemo-refractory (Cref) and/or progressive aggressive non-Hodgkin’s lymphomas (A-NHL) generally have a poor clinical outcome. Autologous stem cell transplantation (SCT) has limited efficacy in this setting. Studies reporting outcomes of allogeneic (Allo) SCT in pts with Cref A-NHL are limited. Methods: 108 pts with A-NHL underwent Allo-SCT between 1988 and 2007 at our institution. 46 A-NHL pts with Cref (i.e pts with <50% reduction in tumor size and/or persistent bone marrow involvement following chemotherapy) or progressive disease (PD) by CT-criteria were eligible for this analysis. Positron emission tomography (PET) or PET/CT scans were not performed to assess response. Results: The median age was 46 years (range 22–63 yrs). 39 pts received matched sibling allografts, while 7 underwent unrelated donor SCT. All except 3 pts received myeloablative conditioning. 38 pts received BU/CY-based conditioning, while BEAM (n=5) or Flu/Bu (n=3) was employed in the remaining pts. Diagnosis included diffuse large B-cell lymphoma (n=18), Burkitt’s lymphoma (n=3), transformed lymphoma (n=5), mantle cell lymphoma (n=11) and T-cell lymphomas (n=9). The median number of prior therapies was 3 (range 1–8). 32 pts had Cref disease, while 14 had PD. 41 pts had stage III/IV disease, 23 had elevated LDH, while 36 had extranodal involvement. Median follow-up of surviving pts following Allo-SCT is 5-yrs. The 5-yr overall survival (OS), progression free survival (PFS), and relapse rate for the whole cohort (n=46) was 38%, 34%, and 35% respectively. Rate of grade II-IV acute graft-versus-host disease (GVHD) was 43% (n=20). Among the 33 evaluable pts rate of chronic GVHD was 75%. Overall non-relapse mortality rate was 37%. No significant difference in the baseline characteristics of pts with Cref and PD was present. The 5-yr OS and PFS rates for pts with Cref and PD were 46% vs. 21% (p-value=0.01; log-rank test), and 46% vs. 7% (p-value=0.0002; log-rank test) respectively. On multivariate analysis only PD at the time of SCT predicted for worse OS and PFS. Conclusion: Our study shows encouraging efficacy of Allo-SCT in a group of A-NHL pts with Cref disease by CT scan-criteria who often fail following Auto-SCT. However outcomes of pts with PD remain dismal despite Allo-SCT, and our data question the practice to perform allografting in A-NHL pts with PD. We hypothesize that PET scans may help better define patients with aggressive NHL appearing not to have responded to salvage chemotherapy by standard CT criteria that still may derive significant benefit from allografting.

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