The clinical value of interim PET/computed tomography scanning in patients with classical Hodgkin's lymphoma and its influence on prognosis in Duhok Province, Kurdistan Region - Northern Iraq.

BACKGROUND: Classical Hodgkin's lymphoma (cHL) is a largely curable cancer, although a percentage of patients experience recurrence or treatment failure. Interim PET(iPET)/computed tomography (CT) scanning after 2-4 rounds of adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy has emerged as a useful predictor of treatment response and survival. The current study aimed to assess the prognostic significance of iPET/CT in patients with cHL treated at Azadi Hematology Oncology Center in Duhok Province, Kurdistan Region, and compare the results to worldwide data.

METHODS: This retrospective analysis comprised 53 patients who had histologically proven cHL treatment between January 2020 and March 2024. PET/CT scans were performed on all patients at the intermediate and end of therapy stages. Deauville scoring was used to categorize the replies. Kaplan-Meier analysis was used to determine survival results.

RESULTS: Interim complete metabolic response (iCR, Deauville 1-3) was observed in 83% of patients, with a corresponding end-of-treatment complete response rate of 93.2%. Patients with iCR had significantly improved overall survival (OS) and progression-free survival (PFS) compared to those with partial response or no response/progression (OS: P  = 0.001; PFS: P  < 0.001). The concordance rate between iPET/CT and final response was 90.6%.

CONCLUSION: iPET/CT is a reliable prognostic indicator in cHL and significantly correlates with OS and PFS. The findings support its use in response-adapted therapy in resource-limited settings like Duhok. These results align with international studies, reinforcing the utility of iPET/CT in guiding treatment modifications.