18F-FDG PET/CT for predicting prognosis of B-cell non-Hodgkin lymphoma patients treated with chimeric antigen receptor T cells: the value of pre-infusion and M1 image
IF 8.6 1区 医学Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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引用次数: 0
Abstract
Purpose
We aimed to evaluate the prognostic value of pre- and post-infusion 18F-FDG PET/CT for B-cell non-Hodgkin lymphoma B-NHL) patients treated with anti-CD19 chimeric antigen receptor T (CAR-T) cells.
Methods
B-NHL patients who received CAR-T therapy and underwent 18F-FDG PET/CT examination one month before (pre-infusion) and after (M1) CAR-T infusion were collected and regularly followed up. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) was recorded for each PET/CT performed, as well as some clinical and laboratory indexes. Progression-free survival (PFS) and overall survival (OS) were endpoints, estimated by the Kaplan-Meier method.
Results
Ninety-three patients were included. The median follow-up time was 21.1 months. Multivariate analysis showed that extranodal (EN) sites and SUVmax at M1 were independent prognostic factors for PFS. Patients with EN sites ≥ 2 had shorter median PFS than those with EN sites < 2 (6.4 months vs. not reached [NR], P = 0.032). Patients with M1 SUVmax ≥ 12.4 had shorter median PFS than those with SUVmax < 12.4 (1.1 months vs. NR, P < 0.001). Regarding OS, International Prognostic Index (IPI) and SUVmax at M1 were strongly associated with subsequent outcomes. The median OS was 14.1 months for patients with IPI ≥ 3, compared with NR for those with IPI < 3 (P = 0.011). Patients with SUVmax < 12.9 at M1 had longer median OS compared to those with SUVmax ≥ 12.9 (NR vs. 12.0 months, P < 0.001).
Conclusion
For B-NHL patients who received CAR-T therapy, M1 PET/CT had a more important prognostic value than the pre-infusion one. EN sites and SUVmax at M1 were independent risk factors for PFS, and IPI and SUVmax at M1 for OS. Integrating the clinical characteristics and PET/CT parameters can be helpful for early decision-making in patient management.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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