代谢参数预测嵌合抗原受体T细胞治疗复发/难治性大B细胞淋巴瘤的存活率和毒性。

IF 3.3 4区 医学 Q2 HEMATOLOGY
Hazim S. Ababneh, Andrea K. Ng, Jeremy S. Abramson, Jacob D. Soumerai, Ronald W. Takvorian, Matthew J. Frigault, Chirayu G. Patel
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引用次数: 0

摘要

CD19靶向嵌合抗原受体(CAR)T细胞疗法彻底改变了复发/难治性大B细胞淋巴瘤(LBCL)患者的治疗。然而,关于定量18F-氟脱氧葡萄糖正电子发射断层扫描计算机断层扫描(FDG PET/CT)参数对CAR T相关结果和毒性的预后价值的影响的现有数据是有限的。因此,我们旨在评估CAR T治疗前后代谢参数对CAR T细胞治疗后存活率和毒性的预测价值。在接受商业CD19靶向CAR T细胞治疗的LBCL患者的单一机构数据库中,对59名CAR T输注前后进行PET/CT扫描的患者进行了回顾性鉴定和分析。中位随访时间为10.7个月[四分位间距(IQR):2.6-25.5个月]。CAR T后的总缓解率(完全缓解CR和部分缓解CR)和CR率分别为76%(n=45)和53%(n=31)。在单变量分析中,CAR T前总损伤糖酵解(TLG)和代谢肿瘤体积(MTV)较低可预测CAR T后的总体反应改善(分别为OR=4.7,p=0.01,OR=9.5,p=0.03)和CR(分别为OR=12.4,p=0.0004,OR=10.9,p=0.001)。高TLG pre-CAR T与细胞因子释放综合征相关(CRS,OR=3.25,p=0.04)。高MTV pre-CAR T与发生免疫效应细胞神经毒性综合征(ICANS)事件相关(OR=4.3,p=0.01),CAR前的高SUV T与3-4级神经事件相关(OR=12,p=0.01)。CAR后的高MTV/TLG/SUVmax与较差的总生存率(OS)显著相关。在多变量分析中,高TLG CAR前T(HR=2.4,p=0.03)、年龄≥60(HR=2.7,p=0.03。CAR T后高MTV被确定为与OS较差相关的最具预后因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Metabolic parameters predict survival and toxicity in chimeric antigen receptor T-cell therapy-treated relapsed/refractory large B-cell lymphoma

CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has revolutionized treatment for patients with relapsed/refractory large B-cell lymphoma (LBCL). However, data available concerning the impact of the prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) parameters on the CAR T-related outcomes and toxicities are limited. Therefore, we aimed to evaluate the predictive value of pre- and post-CAR T metabolic parameters on survival and toxicities following CAR T-cell therapy. Fifty-nine patients with PET/CT scans done pre-and post-CAR T infusion were retrospectively identified and analyzed in a single institution database of LBCL patients treated with commercial CD19-targeted CAR T-cell therapy. The median follow-up was 10.7 months [interquartile range (IQR): 2.6–25.5 months]. The overall response (complete response-CR and partial response) and CR rates post-CAR T were 76% (n = 45) and 53% (n = 31), respectively. On univariate analysis, low pre-CAR T total lesion glycolysis (TLG) and metabolic tumor volume (MTV) predicted improved overall response post-CAR T (OR = 4.7, p = 0.01, OR = 9.5, p = 0.03, respectively) and CR post-CAR T (OR = 12.4, p = 0.0004, OR = 10.9, p = 0.0001, respectively). High TLG pre-CAR T was correlated with cytokine release syndrome (CRS, OR = 3.25, p = 0.04). High MTV pre-CAR T was correlated with developing immune effector cell neurotoxicity syndrome (ICANS) events (OR = 4.3, p = 0.01), and high SUV pre-CAR T was associated with grade 3–4 neurological events (OR = 12, p = 0.01). High MTV/TLG/SUVmax post-CAR T were significantly associated with inferior Overall survival (OS). On multivariate analysis, high TLG pre-CAR T (HR = 2.4, p = 0.03), age ≥60 (HR = 2.7, p = 0.03), and bulky disease (≥5 cm) at the time of apheresis (HR = 2.5, p = 0.02) were identified to be independent prognostic factors for inferior PFS. High MTV post-CAR T was identified as the most prognostic factor associated with inferior OS.

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来源期刊
Hematological Oncology
Hematological Oncology 医学-血液学
CiteScore
4.20
自引率
6.10%
发文量
147
审稿时长
>12 weeks
期刊介绍: Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged: -Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders -Diagnostic investigations, including imaging and laboratory assays -Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases -Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies -Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems. Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.
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