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[(18)F]FDG-PET/CT 在接受 CAR-T 细胞治疗的 DLBCL 患者中：定义患者预后的潜力

英文原题：[(18)F]FDG-PET/CT in DLBCL-patients treated with CAR-T cell therapy: potential for defining patient prognosis.

查看英文原题

[(18)F]FDG-PET/CT in DLBCL-patients treated with CAR-T cell therapy: potential for defining patient prognosis.

PubMed 2025/06/05（内容时间） Eur J Radiol Open Q2 · IF 3.5（JCR 2025）

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技术：CAR-T弥漫大B细胞淋巴瘤淋巴瘤地区：欧洲
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研究概要

[18F]FDG-PET/CT 的 SUV max 似乎可作为接受 CAR-T 细胞治疗的 DLBCL 患者的预后标志物。此外，在 CAR-T 后[18F]FDG-PET/CT 中获得的临床已确立的 Deauville 分类和 Lugano 疗效标准评分可能是早期治疗失败的指标。

研究思路结论见上方概要

目的

目的：本研究旨在评估[18F]FDG-PET/CT在复发/难治性弥漫大B细胞淋巴瘤（DLBCL）患者接受CAR-T 细胞治疗中的预后价值及治疗监测潜力。材料与方法：

方法

回顾性纳入48例接受CAR-T 细胞治疗的DLBCL患者（平均年龄：60 12岁），在预先设定的时间点（t 0 - t 2）采集的48次[ 18 F]FDG-PET/CT扫描。CAR-T 细胞输注后的中位随访时间为十个月（IQR 6-16）。评估了SUV max、直径乘积之和（SPD）、Deauville评分（DS）和Lugano分类（LC）。获取了临床参数（年龄、性别）。计算了无进展生存期（PFS）和总生存期（OS）的生存时间分析，后者采用Kaplan-Meier法和Cox回归，包括风险比（HR）。P值低于0.05定义为具有统计学显著性。计算了95 %置信区间（CI）。

结果

t 0 时 SUV max > 9.0（以中位数作为阈值）的患者 PFS（p = 0.04）和 OS（p < 0.01）显著更短。根据 LC，t 1（p = 0.02）和 t 2（p < 0.01）时出现疾病进展（PD）与 OS 降低相关。t 0 时 SUV max > 9.0（p = 0.03，HR = 7.0，CI：1.3-40.5）和 t 1 时 DS > 3（p = 0.04，HR = 8.2，CI：1.1-61.3）与 PD 风险增加相关。

展开英文摘要原文
OBJECTIVES

The aim of this study is to evaluate the potential of [ 18 F]FDG-PET/CT in terms of prognostic value and treatment monitoring in relapsed / refractory diffuse large B-cell lymphoma (DLBCL)-patients treated with chimeric antigen receptor T-cell (CAR-T) therapy. MATERIAL &amp;

METHODS

Forty-eight [ 18 F]FDG-PET/CT scans, acquired at pre-defined time points (t 0 - t 2 ) of 18 DLBCL-patients (mean age: 60 12 years) treated with CAR-T cell therapy were retrospectively enrolled. Median time of follow-up was ten months (IQR 6-16) following CAR-T cell infusion. SUV max , sum of the product of diameters (SPD), Deauville score (DS) and Lugano classification (LC) were evaluated. Clinical parameters (age, sex) were obtained. Survival time analyses for progression-free survival (PFS) and overall survival (OS) were calculated, the latter by using the Kaplan-Meier method and Cox regression including a hazard ratio (HR). P values below 0.05 were defined as statistically significant. 95 %-confidence intervals (CI) were calculated.

RESULTS

Patients with a SUV max > 9.0 at t 0 (median as threshold value) had a significantly shorter PFS ( p = 0.04) and OS ( p < 0.01). According to LC, a progressive disease (PD) at t 1 ( p = 0.02) and t 2 ( p < 0.01) was correlated with a reduced OS. SUV max > 9.0 at t 0 ( p = 0.03, HR = 7.0, CI: 1.3-40.5) and DS > 3 at t 1 ( p = 0.04, HR = 8.2, CI: 1.1-61.3) were associated with an increased risk of a PD.

CONCLUSION

SUV max of [ 18 F]FDG-PET/CT seems to be useful as a prognostic marker in DLBCL-patients undergoing CAR-T cell therapy. Furthermore, scores of clinical established Deauville classification and Lugano response criteria acquired at post-CAR-T [ 18 F]FDG-PET/CT might be an indicator for early therapy failure.

论文信息

作者
Peters HA、Bärmann BN、Novruzov E、Weiss D、Boschheidgen M、Ivan VL、Liebers N、Fischer J
单位
Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital D&#xfc;sseldorf, Heinrich-Heine-University D&#xfc;sseldorf, D&#xfc;sseldorf D-40225, Germany.Germany
期刊
European journal of radiology open2025 Jun
原文标识
PubMed 40524784　·　DOI 10.1016/j.ejro.2025.100663

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