Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPSANTOS, Fernanda MariaMARIN, Jose Flavio GomesLIMA, Marcos SantosSILVA-JUNIOR, Wellington FernandesALVES, Lucas Bassolli O.MOREIRA, Frederico R.VELASQUES, Rodrigo DolphiniATANAZIO, Marcelo JunqueiraMAIA, Ana Carolina ArraisBUCHPIGUEL, Carlos A.BUCCHERI, ValeriaROCHA, Vanderson2024-04-052024-04-052024ANNALS OF HEMATOLOGY, v.103, n.1, p.175-183, 20240939-5555https://observatorio.fm.usp.br/handle/OPI/58845Currently, analysis of interim PET (iPET) according to the Deauville score (DS) is the most important predictive factor in Hodgkin lymphoma (HL); however, there is room for improvement in its prognostic power. This study aimed to evaluate the prognostic value of quantitative PET analysis (maximum standard uptake value [SUVmax], total metabolic tumor volume [TMTV] and total lesion glicolysis [TLG]) at baseline (PET0) and iPET in a retrospective cohort of newly diagnosed classical HL. For positive iPET (+ iPET), the reduction of quantitative parameters in relation to PET0 (Delta SUVmax, Delta TMTV and Delta TLG) was calculated. Between 2011 and 2017, 234 patients treated with ABVD were analyzed. Median age was 30 years-old, 59% had advanced stage disease, 57% a bulky mass and 25% a + iPET (DS 4-5). At baseline, high TLG was associated with an increased cumulative incidence of failure (CIF) (p = 0.032) while neither SUVmax, TMTV or TLG were associated with overall survival (OS) or progression-free survival (PFS). In multivariate analysis, only iPET was associated with CIF (p < 0.001). Among Delta SUVmax, Delta TMTV and Delta TLG, only a Delta SUVmax >= 68.8 was significant for PFS (HR: 0.31, CI95%: 0.11-0.86, p = 0.024). A subset of patients with improved PFS amongst + iPET was identified by the quantitative (Delta SUVmax >= 68.8%) analysis. In this real-world Brazilian cohort, with prevalent high-risk patients, quantitative analysis of PET0 did not demonstrate to be prognostic, while a dynamic approach incorporating the Delta SUV(max )to + iPET succeeded in refining a subset with better prognosis. These findings warrant validation in larger series and indicate that not all patients with + iPET might need treatment intensification.engrestrictedAccessHodgkin lymphomaPositron emission tomographyMetabolic tumor volumeTotal lesion glycolysispositron-emission-tomographymetabolic tumor volumeadvanced-stageprognostic valuef-18-fdg petresponse assessmentadapted treatmentchemotherapytherapycyclesarticleCopyright SPRINGER10.1007/s00277-023-05461-6Hematology1432-0584