2017, Number 1
Rev Hematol Mex 2017; 18 (1)
Is it useful to perform an interim PET-CT to guide the initial treatment of patients with Hodgkin’s lymphoma? Cost-benefit in the real world
Gómez-De León A, Rivas-García PE, González-López EE, Medellín-Ramos B, Gutiérrez-Aguirre CH, Cantú-Rodríguez OG, Jaime-Pérez JC, Gómez-Almaguer D
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ABSTRACTObjetive: To evaluate the cost-effectiveness of performing an interim PET-CT (PET-CTi) after cycles 2-3 of ABVD in patients with Hodgkin’s lymphoma, as a model for application in Mexico and other developing countries.
Material and Method: An ambispective study was done including patients with Hodgkin’s lymphoma who underwent PET-CTi.
Results: A total of 20 patients were followed for 25 months. At diag-nosis, Ann Arbor stage was I-II in 70%. Sixteen PET-CTi scans were negative and in complete remission; 4/20 were positive. At the end of treatment, patients with a negative PET-CTi were still in complete remission, one relapsed later. Two of the four PET-CTi-positive patients were in complete remission; one relapsed later, while the remainder had progressive disease. The progression-free survival of patients with negative and positive PET-CT was 94% and 25%, respectively.
Conclusion: PET-CTi is able to predict prognosis in any clinical stage. Our cost-effectiveness analysis suggests that it is feasible to perform an interim PET-CTi before the fourth cycle of ABVD despite its high cost, as eventually costs will balance. This is a promising strategy, which should be reproduced in Mexico and other developing countries.