(18)F-FDG PET/CT 预测接受 CAR-T 细胞治疗的 B 细胞非霍奇金淋巴瘤患者预后：输注前和 M1 图像的价值

We aimed to evaluate the prognostic value of pre- and post-infusion 18 F-FDG PET/CT for B-cell non-Hodgkin lymphoma B-NHL) patients treated with anti-CD19 chimeric antigen receptor T (CAR-T) cells.

B-NHL patients who received CAR-T therapy and underwent 18 F-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.

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).

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. CLINICAL TRIAL NUMBER: Not applicable.