Aggressive non-Hodgkin lymphoma: Early prediction of outcome with Ga-67 scintigraphy

PURPOSE: To evaluate use of gallium 67 scintigraphy early during chemothera py to predict the outcome in patients with aggressive non-Hodgkin lymphoma. MATERIALS AND METHODS: Among 118 patients, Ga-67 scintigraphy was performed after one cycle of chemotherapy in 51 patients, after a median of 3.5 cycl es in 97 patients, and both in 30 patients. Computed tomography (CT) was pe rformed after a median of 3.5 cycles of treatment in 87 patients. The failu re-free survival was compared between patients with positive or negative Ga -67 or CT scans by using the log-rank test. Multivariate analysis helped de termine the relation: between Ga-67 scintigraphic and CT findings and the o utcome. RESULTS: The differences in failure-free survival between patients with pos itive versus negative Ga-67 scans after one cycle of treatment (P<.001) and at midtreatment (P <.001) were significant. There was no statistically sig nificant difference in failure-free survival between patients with positive versus negative CT findings during treatment. In multivariate analysis, Ga -67 scintigraphy after one cycle (P <.045) and at midtreatment (P <.006) wa s an independent factor associated with outcome. CONCLUSION: Gallium 67 scintigraphic findings after One cycle Of chemothera py and at midtreatment are predictive of outcome in patients with aggressiv e non-Hodgkin lymphoma. CT findings are not predictive. Early Ga-67 scintig raphy during chemotherapy is a good indicator of patients who may benefit f rom a change to a more aggressive treatment. A future study is necessary to investigate the potential effect of early change of treatment.