B-NHL 中的免疫微环境及其对 CAR-T 治疗结局的影响

B-cell non-Hodgkin's lymphoma (B-NHL) is a highly heterogeneous tumor. Currently, CAR-T cells have been widely used in the treatment of B-cell lymphomas, with a complete response rate reaching 40%-60%. More and more studies have shown that the immune microenvironment plays an important role in the occurrence and development of B-NHL.

However, it is still unclear what role the tumor microenvironment plays in the effect of CAR-T therapy on B-NHL.

We analyzed the components of 44 tumor tissue biopsy samples from 36 patients with relapsed or refractory Diffuse large B-cell lymphoma (R/R DLBCL) in our center to explore the immune cell components in the tumor microenvironment that correlated with improved clinical outcomes of CAR-T therapy. The median follow-up time was 8. 5 months.

We analyzed the impact of various cells on patient survival and identified multiple prognostic protective factors and risk factors. Among them, Treg cells (P < 0. 009; HR = 0. 32) are a key prognostic protective factor that associated with the efficacy of CAR-T therapy.

Further analysis of tumor biopsy samples before and after CAR-T treatment in the same patients revealed that higher Treg cells were associated with the better CAR-T efficacy and were associated with sustained CAR-T persistence. There were more Treg cells in biopsy samples without CAR-T cells remaining after CAR-T treatment.

The overall response rate in non-residual CAR-T cells group was 61. 5% (n = 8), consisting of CR (30. 8%, n = 4), PR (30. 8%, n = 4), SD (7. 7%, n = 1), and PD (30. 8%, n = 4) compared to the residual CAR-T cells group (PR: n = 1, 25%).