CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
使用 (18)F-FDG PET/CT 观察 Tisagenlecleucel CAR-T 细胞治疗后网状内皮系统的代谢变化
英文原题：Metabolic changes in reticuloendothelial system following Tisagenlecleucel chimeric antigen receptor T cell (CAR-T) therapy using (18)F-FDG PET/CT.
查看英文原题
Metabolic changes in reticuloendothelial system following Tisagenlecleucel chimeric antigen receptor T cell (CAR-T) therapy using (18)F-FDG PET/CT.
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研究概要
氟-18-FDG PET/CT 显示，在 tisagenlecleucel 治疗后，淋巴瘤淋巴结、骨髓和脾脏的代谢活性降低。然而，肝脏的变化无统计学显著性。这些发现表明，TisagenlecleucelCAR-T 细胞治疗在网状内皮系统内诱导了广泛的全身性代谢反应。
研究思路结论见上方概要
目的
评估弥漫大B细胞淋巴瘤（DLBCL）患者接受Tisagenlecleucel治疗后，淋巴瘤淋巴结病变及其他网状内皮器官——骨髓、脾脏和肝脏——代谢活性的变化，采用氟-18-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）。
方法
回顾性分析了41例接受Tisagenlecleucel治疗的DLBCL患者（25例男性，16例女性；年龄：59.15 13.78，范围：29-81岁）的氟-18-FDG-PET/CT扫描。在基线和治疗后对淋巴瘤淋巴结、骨髓、脾脏和肝脏的代谢活性进行了定量，两次扫描之间的平均间隔为121.2 63.9天（范围：35-437天）。淋巴瘤淋巴结的部分容积校正总病变糖酵解（pvcTLG）和总代谢肿瘤体积（TMTV），以及治疗前后骨髓的平均平均标准化摄取值（SUVmean），使用Wilcoxon符号秩检验进行比较，而脾脏和肝脏的平均SUVmean则使用双尾配对t检验进行比较。
结果
氟-18-FDG PET/CT显示治疗后淋巴瘤淋巴结、骨髓和脾脏的代谢活性显著降低。对于淋巴瘤淋巴结，pvcTLG从539.22 831.00降至491.27 1068.35（P<0.001），80.5%的患者观察到降低，TMTV从46.06 63.07降至30.40 41.62（P<0.001）。骨髓和脾脏的平均SUV分别从1.31 0.37显著降至1.16 0.33（P=0.002），以及从1.96 0.68降至1.77 0.45（P=0.017）。然而，肝脏SUVmean从2.30 0.42至2.31 0.40，无统计学显著变化（P=0.21）。
展开英文摘要原文
OBJECTIVE
To evaluate changes in metabolic activity in lymphoma adenopathy and other reticuloendothelial organs-bone marrow, spleen, and liver, in patients with diffuse large B-cell lymphoma (DLBCL) following Tisagenlecleucel therapy, using fluorine-18-fluorodeoxyglucse ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT).
MATERIALS AND METHODS
Fluorine-18-FDG-PET/CT scans from 41 DLBCL patients (25 males, 16 females; age: 59.15 13.78, range: 29-81 years) treated with Tisagenlecleucel were retrospectively analyzed. Metabolic activity was quantified in lymphoma adenopathy, bone marrow, spleen, and liver at baseline and post-treatment, with a mean interval of 121.2 63.9 days (range: 35-437 days) between scans. The partial volume-corrected total lesion glycolysis (pvcTLG) and total metabolic tumor volume (TMTV) for lymphoma adenopathy, and average mean standardized uptake value (SUVmean) for bone marrow before and after treatment, were compared using the Wilcoxon signed-rank test, whereas the average SUVmean of spleen and liver was compared using a two-tailed paired t-test.
RESULTS
Fluorine-18-FDG PET/CT showed significant reductions in metabolic activity of lymphoma adenopathy, bone marrow, and spleen after treatment. For lymphoma adenopathy, pvcTLG decreased from 539.22 831.00 to 491.27 1068.35 (P<0.001), with reduction observed in 80.5% of patients, and TMTV decreased from 46.06 63.07 to 30.40 41.62 (P<0.001). Mean SUV of bone marrow and spleen decreased significantly from 1.31 0.37 to 1.16 0.33 (P=0.002), and from 1.96 0.68 to 1.77 0.45 (P=0.017), respectively. However, hepatic SUVmean showed no statistically significant changes from 2.30 0.42 to 2.31 0.40 (P=0.21).
CONCLUSION
Fluorine-18-FDG PET/CT demonstrated a decrease in metabolic activity of lymphoma adenopathy, bone marrow, and spleen, after tisagenlecleucel therapy. However, changes in the liver were not statistically significant. These findings suggest that Tisagenlecleucel chimeric antigen receptor T cell (CAR-T) therapy induces a broad systemic metabolic response within the reticuloendothelial system.
论文信息
- 作者
- Singh SB、Gandhi OH、Haghshenas C、Shrestha BB、Ahmed M、Gujral J、Niazi SK、Khanal K
- 单位
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA. m.e.rootwelt-revheim@medisin.uio.no, mona.elisabeth.revheim@ous-hf.no.United States
- 期刊
- Hellenic journal of nuclear medicine2026 Jan-Apr
- 原文标识
- PubMed 42001436 · DOI 10.1967/s002449912940