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Sesques, Pierre; Tordo, Jérémie; Ferrant, Emmanuelle; Safar, Violaine; Wallet, Florent; Dhomps, Anthony; Brisou, Gabriel; Bouafia, Fadhela; Karlin, Lionel; Ghergus, Dana; Golfier, Camille; Lequeu, Helène; Lazareth, Anne; Vercasson, Marlène; Hospital-Gustem, Carole; Schwiertz, Vérane; Choquet, Marion; Sujobert, Pierre; Novelli, Silvana; Mialou, Valérie; Hequet, Olivier; Carras, Sylvain; Fouillet, Ludovic; Lebras, Laure; [...]

Prognostic Impact of 18F-FDG PET/CT in Patients With Aggressive B-Cell Lymphoma Treated With Anti-CD19 Chimeric Antigen Receptor T Cells

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  • Media type: E-Article
  • Title: Prognostic Impact of 18F-FDG PET/CT in Patients With Aggressive B-Cell Lymphoma Treated With Anti-CD19 Chimeric Antigen Receptor T Cells
  • Contributor: Sesques, Pierre; Tordo, Jérémie; Ferrant, Emmanuelle; Safar, Violaine; Wallet, Florent; Dhomps, Anthony; Brisou, Gabriel; Bouafia, Fadhela; Karlin, Lionel; Ghergus, Dana; Golfier, Camille; Lequeu, Helène; Lazareth, Anne; Vercasson, Marlène; Hospital-Gustem, Carole; Schwiertz, Vérane; Choquet, Marion; Sujobert, Pierre; Novelli, Silvana; Mialou, Valérie; Hequet, Olivier; Carras, Sylvain; Fouillet, Ludovic; Lebras, Laure; [...]
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2021
  • Published in: Clinical Nuclear Medicine
  • Language: English
  • DOI: 10.1097/rlu.0000000000003756
  • ISSN: 1536-0229; 0363-9762
  • Origination:
  • Footnote:
  • Description: <jats:sec> <jats:title>Purpose of the Report</jats:title> <jats:p>We aimed to evaluate the role of <jats:sup>18</jats:sup>F-FDG PET/CT in predicting patient outcome following chimeric antigen receptor T (CAR T) cells infusion in aggressive B-cell lymphoma.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p> <jats:sup>18</jats:sup>F-FDG PET/CT data before leukapheresis, before CAR T-cell infusion and 1 month (M1) after CAR T-cell infusion, from 72 patients were retrospectively analyzed. SUVmax, total lesion glycolysis (TLG), metabolic tumor volume (MTV), and parameters describing tumor kinetics were calculated for each <jats:sup>18</jats:sup>F-FDG PET/CT performed. The aim was to evaluate the prognostic value of <jats:sup>18</jats:sup>F-FDG PET/CT metabolic parameters for predicting progression-free survival (PFS) and overall survival (OS) following CAR T-cell therapy.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Regarding PFS, ∆MTV<jats:sup>pre-CAR</jats:sup> and ∆TLG<jats:sup>pre-CAR</jats:sup> were found to be more discriminating compared with metabolic parameters at preinfusion. Median PFS in patients with a ∆MTV<jats:sup>pre-CAR</jats:sup> of less than 300% was 6.8 months (95% confidence interval [CI], 2.8 months to not reached) compared with 2.8 months (95% CI, 0.9–3.0 months) for those with a value of 300% or greater (<jats:italic toggle="yes">P</jats:italic> = 0.004). Likewise, median PFS in patients with ∆TLG<jats:sup>pre-CAR</jats:sup> of less than 420% was 6.8 months (95% CI, 2.8 months to not reached) compared with 2.7 months (95% CI, 1.3–3.0 months) for those with a value of 420% or greater (<jats:italic toggle="yes">P</jats:italic> = 0.0148). Regarding OS, metabolic parameters at M1 were strongly associated with subsequent outcome. SUVmax at M1 with a cutoff value of 14 was the most predictive parameter in multivariate analysis, outweighing other clinicobiological variables (<jats:italic toggle="yes">P</jats:italic> &lt; 0.0001).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Disease metabolic volume kinetics before infusion of CAR T cells seems to be superior to initial tumor bulk itself for predicting PFS. For OS, SUVmax at M1 might adequately segregate patients with different prognosis.</jats:p> </jats:sec>