Role of Surveillance CT in Detection of Pre-Clinical Relapse in Patients with B-Cell lymphoma: A Retrospective Study
Shorouq Sabry Rizq Aly;
Abstract
Introduction
N
on-Hodgkin lymphoma is a fairly common tumor according to Surveillance, Epidemiology, and End Results (SEER), which states that NHL accounts for 4.3% of all new cancer cases per year in USA. Its incidence is almost doubling annually (SEER database, 2013). In Egypt, lymphoma is the fourth most common tumor in adults, with B-Cell lymphoma being the commonest subtype of NHL accounting for about 49% of all NHL cases presenting to NCI (Allah HG et.al., 2014).
With such a disease burden, and about one third relapsed NHL patients after complete remission, on-going research on new methods of detection, staging and response assessment is always making the highlights, with relapse detection being of major concern, especially with the new curative methods made available for relapsed cases. The high risk of radiation induced malignancies associated with frequent radiological follow-up scans for those long term survivors also raised the red flag for re-establishing a risk-benefit oriented follow-up plan for those patients (Lalit et. al., 2014).
Careful history taking, thorough physical examination and good clinical judgment are the cornerstones of an appropriate follow-up. Many recommendations have been published for formulating follow-up plans according to histology; curable versus non-curable. For curable conditions (HL, DLBCL) the likelihood of relapse decreases with time, so the frequency of follow-up decreases accordingly, and the contrary goes for non-curable conditions (mantle cell lymphoma and follicular lymphoma) (Bruce et.al, 2014).
Although most guidelines do not recommend whole body CT scan as part of routine follow-up for patients who went through complete remission, it is still adopted by many clinicians as part of their patients’ follow-up visits. However, its value for assessment of early asymptomatic relapse is questionable, let alone its influence on the overall outcome compared to other modalities of relapse detection (Tung-Liang Lin et. al., 2012).
N
on-Hodgkin lymphoma is a fairly common tumor according to Surveillance, Epidemiology, and End Results (SEER), which states that NHL accounts for 4.3% of all new cancer cases per year in USA. Its incidence is almost doubling annually (SEER database, 2013). In Egypt, lymphoma is the fourth most common tumor in adults, with B-Cell lymphoma being the commonest subtype of NHL accounting for about 49% of all NHL cases presenting to NCI (Allah HG et.al., 2014).
With such a disease burden, and about one third relapsed NHL patients after complete remission, on-going research on new methods of detection, staging and response assessment is always making the highlights, with relapse detection being of major concern, especially with the new curative methods made available for relapsed cases. The high risk of radiation induced malignancies associated with frequent radiological follow-up scans for those long term survivors also raised the red flag for re-establishing a risk-benefit oriented follow-up plan for those patients (Lalit et. al., 2014).
Careful history taking, thorough physical examination and good clinical judgment are the cornerstones of an appropriate follow-up. Many recommendations have been published for formulating follow-up plans according to histology; curable versus non-curable. For curable conditions (HL, DLBCL) the likelihood of relapse decreases with time, so the frequency of follow-up decreases accordingly, and the contrary goes for non-curable conditions (mantle cell lymphoma and follicular lymphoma) (Bruce et.al, 2014).
Although most guidelines do not recommend whole body CT scan as part of routine follow-up for patients who went through complete remission, it is still adopted by many clinicians as part of their patients’ follow-up visits. However, its value for assessment of early asymptomatic relapse is questionable, let alone its influence on the overall outcome compared to other modalities of relapse detection (Tung-Liang Lin et. al., 2012).
Other data
| Title | Role of Surveillance CT in Detection of Pre-Clinical Relapse in Patients with B-Cell lymphoma: A Retrospective Study | Other Titles | دور الأشعة المقطعية المراقبة في اكتشاف الانتكاس ما قبل السريري في ليمفوما الخلايا البائية: دراسة استعادية | Authors | Shorouq Sabry Rizq Aly | Issue Date | 2017 |
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