FDG-PET/CT 是预测和评估非霍奇金淋巴瘤（NHL）嵌合抗原受体（CAR）T 细胞治疗疗效的有力工具

Chimeric antigen receptor (CAR) T-cell therapy has dramatically shifted the landscape of treatment especially for Non-Hodgkin-Lymphoma (NHL).

This study evaluates the role of fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in NHL treated with CAR T-cell therapy concerning response assessment and prognosis.

We evaluated 34 patients with NHL who received a CAR T-cell therapy between August 2019 and July 2022. All patients underwent a pre-therapeutic FDG-PET/CT (PET-0) 6 days prior and a post-therapeutic FDG-PET/CT (PET-1) 34 days after CAR T-cell therapy. Deauville score (DS) was used for evaluation of response to therapy and compared to a minimum follow-up of 5 months. 19/34 (55. 9%) patients achieved DS 3 on PET-1, the remaining 15 (44. 1%) patients had DS > 3 on PET-1.

14/19 patients with DS 3 on PET-1 had no relapsed or refractory (r/r)-disease and were still alive at last follow-up. The other 5 patients had r/r-disease and 4 of these died. Except for two patients who had no r/r-disease, all other patients (13/15) with DS > 3 on PET-1 had r/r-disease and 12 of these subsequently died. Patients with DS 3 on PET-1 had significantly better progression free survival (PFS; HR: 5. 7; p < 0. 01) and overall survival (OS; HR: 5. 0; p < 0. 01) compared to patients with DS > 3 on PET-1.

In addition, we demonstrated that patients with DS 4 on PET-0 tended to have longer PFS (HR: 3. 6; p = 0. 05). Early FDG-PET/CT using the established DS after CAR T-cell therapy is a powerful tool to evaluate response to therapy.