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Staging and Treatment Response Evaluation in Malignant Lymphomas – Czech Lymphoma Study Group Recommendations According to Criteria Revised in 2014 (Lugano Classification)


Authors: A. Sýkorová 1;  R. Pytlík 2;  H. Mociková 3;  D. Belada 1;  K. Benešová 2;  T. Papajík 4;  A. Janíková 5;  D. Šálek 5;  V. Procházka 4;  S. Vokurka 6;  V. Campr 7;  P. Klener 2;  K. Kubáčková 8;  M. Trněný 2
Authors‘ workplace: IV. interní hematologická klinika LF UK a FN Hradec Králové 1;  I. interní klinika 1. LF UK a VFN v Praze 2;  Interní hematologická klinika 3. LF UK a FN Královské Vinohrady, Praha 3;  Hematoonkologická klinika LF UP a FN Olomouc 4;  Interní hematologická a onkologická klinika LF MU a FN Brno 5;  Hematologicko-onkologické oddělení, FN Plzeň 6;  Ústav patologie a molekulární medicíny, 2. LF UK a FN v Motole, Praha 7;  Onkologická klinika 2. LF UK a FN v Motole, Praha 8
Published in: Klin Onkol 2016; 29(4): 295-302
Category: Short Communication
doi: https://doi.org/10.14735/amko2016295

Overview

Background:
Recent advances in the use of the imaging modalities, especially PET/CT, and their utilization for determining clinical stage (CS) and assessment treatment response (TR) in malignant lymphomas, along with development of prognostic tools and new treatment modalities, formed the basis for the revised criteria for evaluating CS and TR (published as the Lugano classification, 2014).

Materials and Methods:
The authors summarize the new Lugano recommendations (published in 2014) and the changes from the criteria published in 2007. Moreover, discussion of the changes places emphasis on practical use. The practicality of the Lugano classification, 2014 was the subject of consensus meeting at the annual meeting of the Cooperative Lymphoma Study Group (CLSG) in March 2015. This study reports the final consensus. The CLSG recommends use of the Lugano classification, 2014, but recommends some modifications.

Conclusions:
Standardization of the criteria used to determine CS and TR in malignant lymphomas has led to improvements in initial staging and assessment of TR. The criteria are helpful for unifying response assessment in clinical trials and simplify the work of regulatory agencies (e.g., the EMA and the Czech State Institute for Drug Control) when registering new drugs. It also allows evaluation of treatment outcomes outside clinical trials, for example within the CLSG prospective registry of patients with newly diagnosed lymphoma.

Key words:
malignant lymphoma – computed tomography – positron emission tomography – staging – treatment response

This work was supported by the grant Prvouk P27/2012 of the Third Faculty of Medicine, Charles University in Prague and by the grant of the Czech Lymphoma Study Group No. NT12193-5/2011.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
24. 1. 2016

Accepted:
16. 2. 2016


Sources

1. Shipp MA. Prognostic factors in aggressive non-Hodgkin‘s lymphoma: who has „high-risk“ disease? Blood 1994; 83(5): 1165– 1173.

2. Sehn LH, Berry B, Chhanabhai M et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 2007; 109(5): 1857– 1861.

3. Solal-Céligny P, Roy P, Colombat P et al. Follicular lymphoma international prognostic index. Blood 2004; 104(5): 1258– 1265.

4. Federico M, Bellei M, Marcheselli L. Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project. J Clin Oncol 2009; 27(27): 4555– 4562. doi: 10.1200/ JCO.2008.21.3991.

5. Hoster E, Dreyling M, Klapper W et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 2008; 111(2): 558– 565.

6. Gallamini A, Stelitano C, Calvi R et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood 2004; 103(7): 2474– 2479.

7. Ferreri AJ, Blay JY, Reni M et al. Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group Experience. J Clin Oncol 2003; 21(2): 266– 272.

8. Buske C, Leblond V. How to manage Waldenstrom’s macroglobulinemia. Leukemia 2013; 27(4): 762– 772. doi: 10.1038/ leu.2013.36.

9. Owen RG, Kyle RA, Stone MJ et al. Response assessment in Waldenstrom macroglobulinaemia: update from the VIth International Workshop. Br J Haematol 2013; 160(2): 171– 176. doi: 10.1111/ bjh.12102.

10. Hartmann S, Eichnauer DA, Plutschow A et al. The prog­nostic impact of variant histology in nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group (GHSG). Blood 2013; 122(26): 4246– 4252. doi: 10.1182/ blood-2013-07-515825.

11. Fanale M. A novel prognostic scoring system for NLPHL. Blood 2013; 122(26): 4154– 4155. doi: 10.1182/ blood-2013-11-533109.

12. Savage KJ, Zeynalova S, Kansara RR et al. Validation of prognostic model to assess the risk of CNS disease in patients with agressive B-cell lymphoma. 56th ASH Annual Meeting and Exposition 2014, abstr. 394. CA: San Francisko, December 6– 9, 2014.

13. Procházka V, Pytlík R, Janíková A et al. A new prognostic score for elderly patients with diffuse large B-cell lymphoma treated with R-CHOP: the prognostic role of blood monocyte and lymphocyte counts is absent. PLOS One 2014; 9: e102594. doi: 10.1371/ journal.pone.0102594.

14. Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin’s disease. International Prognostic Factors Project on Advanced Hodgkin’s Disease. N Engl J Med 1998; 339(21): 1506– 1514.

15. Rosenberg SA. Validity of the Ann Arbor staging classification for the non-Hodgkin‘s lymphomas. Cancer Treat Rep 1977; 61(6): 1023– 1027.

16. Musshoff K. Clinical staging classification of non-Hodgkin‘s lymphomas (author‘s transl). Strahlentherapie 1977; 153(4): 218– 221.

17. Cheson BD, Horning SJ, Coiffier B et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas: NCI Sponsored International Working Group. J Clin Oncol 1999; 17(4): 1244– 1253.

18. Cheson BD, Fisher RI, Barrington SF et al. Recommendation for initial evaluation, staging, and response assessment of Hodgkin and Non-Hodgkin lymphoma: the Lugano Classification. J Clin Oncol 2014; 32(27): 3059– 3068.

19. Rosenberg SA. Report of the committee on the staging of Hodgkin’s disease. Cancer Res 1966; 26: 1310.

20. Gupta RK, Gospodarowicz MK, Lister TA. Clinical evaluation and staging of Hodgkin’s disease. In: Mauch PM, Armitage JO, Diehl V et al (eds). Hodgkin’s disease. 1st ed. Philadelphia: Lippincott Williams & Wilkins 1999: 223– 240.

21. Carbone PP, Kaplan HS, Musshoff K et al. Report of the committee on Hodgkin’s disease staging classification. Cancer Res 1971; 31(11): 1860– 1861.

22. Lister TA, Crowther D, Sutcliffe SB et al. Report of a com­mitee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 1989; 7(11): 1630– 1636.

23. Cheson BD, Pfistner B, Juweid ME et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25(5): 579– 586.

24. Moog F, Bangerter M, Diederichs CG et al. Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET in nodal staging. Radiology 1997; 203(3): 795– 800.

25. Barrington SF, Mikhaeel NG, Kostakoglu L et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the International conference on malignant lymphomas imaging working group. J Clin Oncol 2014; 32(27): 3048– 3058.

26. Zhang XM, Aguilera N. New immunohistochemistry for B-cell lymphoma and Hodgkin lymphoma. Arch Pathol Lab Med 2014; 138(12): 1666– 1672. doi: 10.5858/ arpa.2014-0058-RA.

27. Arber DA. Molecular dia­gnostic approach to non-Hodgkin’s Lymphoma. J Mol Dia­gn 2000; 2(4): 178– 190.

28. Lenz G, Wright GW, Emre NC et al. Molecular subtypes of diffuse large B-cell lymphoma arise by distinct genetic pathways. Proc Natl Acad Sci U S A 2008; 105(36): 13520– 13525. doi: 10.1073/ pnas.0804295105.

29. Adam Z, Krejčí M, Vorlíček J et al. Maligní non-Hodgkinské lymfomy. In: Adam Z, Krejčí M, Vorlíček J et al (eds). Hematologie –  přehled maligních hematologických nemocí. 2. vyd. Praha: Grada 2008: 105– 167.

30. Belada D, Trněný M, Campr V et al. Léčebná doporučení Kooperativní lymfomové skupiny. 5. vyd. Hradec Králové: HK CREDIT s.r.o. 2013: 17– 40.

31. Hutchings M, Loft A, Hansen M et al. Position emission tomography with or without computed tomography in the primary staging of Hodgkin’s lymphoma. Haematologica 2006; 91(4): 482– 489.

32. Elstrom R, Leonard JP, Coleman M et al. Combined PET and low-dose, noncontrast CT scanning obviates the need for additional dia­gnostic contrast-enhanced CT scans in patients undergoing staging or restaging for lymphoma. Ann Oncol 2008; 19(10): 1770– 1773. doi: 10.1093/ annonc/ mdn282.

33. Pelosi E, Pregno P, Penna D et al. Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/ computed tomography (FDGPET/ CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma. Radiol Med 2008; 113(4): 578– 590. doi: 10.1007/ s11547-008-0264-7.

34. Sýkorová A, Belada D, Smolej L et al. Určování rozsahu onemocnění u non-Hodgkinových lymfomů –  doporučení Kooperativní lymfomové skupiny. Klin Onkol 2010; 23(3): 146 – 154 .

35. Saboo SS, Krajewski KM, O’Regan KN et al. Spleen in haematological malignancies: spectrum of imag­ing findings. Br J Radiol 2012; 85(1009): 81– 92. doi: 10.1259/ bjr/ 31542964.

36. Lamb PM, Lund A, Kanagasabay RR et al. Spleen size: how well do linear ultrasound measurements correlate with three-dimensional CT volume assessments? Br J Radiol 2002; 75(895): 573– 577.

37. Bezerra AS, D’Ippolito G, Faintuch S et al. Determination of splenomegaly by CT: is there a place for a single measurement? AJR Am J Roentgenol 2005; 184(5): 1510– 1513.

38. Spielmann AL, DeLong DM, Kliewer MA. Sonographic evaluation of spleen size in tall healthy athletes. Am J Roentgenol 2005; 184(1): 45– 49.

39. Adams HJ, Kwee TC, de Keizer B et al. Systematic review and meta-analysis on the dia­gnostic performance of FDG-PET/ CT in detecting bone marrow involvement in newly dia­gnosed Hodgkin lymphoma: is bone marrow bio­psy still necessary? Ann Oncol 2014; 25(5): 921– 927. doi: 10.1093/ annonc/ mdt533.

40. Salau PY, Gastinne T, Bodet-Milin C et al. Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkin‘s lymphoma: a reflection of disease infiltration or just inflammation? Eur J Nucl Med Mol Imaging 2009; 36(11): 1813– 1821. doi: 10.1007/ s00259-009-1183-0.

41. Chung R, Lai R, Wei P et al. Concordant but not diskordant bone marrow involvement in diffuse large B-cell lymphoma predicts a poor clinical outcome independent of the International Prognostic Index. Blood 2007; 110(4): 1278– 1282.

42. Sehn LH, Scott DW, Chhanabhai M. Impact of concordant and discordant bone marrow involvement on outcome in diffuse large B-cell lymphoma treated with R-CHOP. J Clin Oncol 2011; 29(11): 1452– 1457. doi: 10.1200/ JCO.2010.33.3419.

43. Shim H, Oh JI, Park SH et al. Prognostic impact of concordant and discordant cytomorphology of bone marrow involvement in patients with diffuse, large, B-cell lymphoma treated with R-CHOP. J Clin Pathol 2013; 66(5): 420– 425. doi: 10.1136/ jclinpath-2012-201158.

44. Ptacnik V, Benesova K, Cmunt E et al. What do we miss and get if we replace bone marrow bio­psy in DLBCL with paging PET/ CT. Hematol Oncol 2015; 33: 3125.

45. Khan AB, Barrington SF, Mikhaeel NG et al. PET-CTstaging of DLBCL accurately identifies and provides new insight into the clinical significance of bone marrow involve­ment. Blood 2013; 122(1): 61– 67. doi: 10.1182/ blood-2012-12-473389.

46. Berthet L, Cochet A, Kanoun S et al. In newly dia­g­nosed diffuse large B-cell lymphoma, determination of bone marrow involvement with 18F-FDGPET/ CT provides better dia­gnostic performance and prognostic stratification than does bio­psy. J Nucl Med 2013; 54(8): 1244– 1250. doi: 10.2967/ jnumed.112.114710.

47. Han HS, Escalón MP, Hsiao B et al. High incidence of false-positive PET scans in patients with aggressive non-Hodgkin‘s lymphoma treated with rituximab-contain­ing regiment. Ann Oncol 2009; 20(2): 309– 318. doi: 10.1093/ annonc/ mdn629.

48. Juweid M, Cheson BD. Positron emission tomography (PET) in post-therapy assessment of cancer. N Engl J Med 2006; 354(5): 496– 507.

49. Lin C, Itti E, Haioun C et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med 2007; 48(10): 1626– 1632.

50. Boellaard R, Oyen WJ, Hoekstra CJ et al. The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials. Eur J Nucl Med Mol Imaging 2008; 35(12): 2320– 2333. doi: 10.1007/ s00259-008-0874-2.

51. Barrington SF, Qian W, Somer EJ et al. Concordance between four European centres of PET reporting criteria designed for use in multicentre trials in Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2010; 37(10): 1824– 1833. doi: 10.1007/ s00259-010-1490-5.

52. Meignan M, Gallamini A, Haioun C et al. Report on the First international workshop on interim-PET scan in lymphoma. Leuk Lymphoma 2009; 50(8): 1257– 1260. doi: 10.1080/ 10428190903040048.

53. Barrington SF, Mikhaeel NG. When should FDG-PET be used in the modern management of lymphoma? Br J Haematol 2014; 164(3): 315– 328. doi: 10.1111/ bjh.12601.

54. Kinahan PE, Fletcher JW. Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to ther­apy. Semin Ultrasound CT MR 2010; 31(6): 496– 505. doi: 10.1053/ j.sult.2010.10.001.

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