PET/CT对CAR-T治疗的弥漫大B细胞淋巴瘤患者的预后预测的价值

Roles of PET/CT in Predicting the Prognosis of Diffuse Large B Cell Lymphoma Patients Treated with Chimeric Antigen Receptor T Cell Therapy

目的:探讨PET/CT对接受CAR-T治疗的DLBCL患者预后预测的价值。方法:回顾性分析13例接受CAR-T治疗的R/R DLBCL患者的PET/CT显像特点。患者接受CAR-T治疗前后,测量反映肿瘤代谢负荷的参数,如肿瘤代谢体积(MTV)和总病变糖酵解(TLG)。结果:与低肿瘤负荷的患者相比,基线MTV较大或长径总和较长的患者总生存期(OS)较短。在CAR-T治疗的12周内达到完全缓解(CR)、部分缓解(PR)和轻微缓解(MR)的患者中无进展生存期(PFS)和OS期均优于12周内未缓解的患者。此外,还发现2例增强CT评估为PR的患者,经PET/CT检查评估为完全代谢缓解(CMR)。结论:PET/CT对接受CAR-T治疗的复发或难治DLBCL患者预后及疗效评价具有重要的价值。

Objective:To investigate the prognosis prediction value of PET/CT in DLBCL patients treated with CAR-T therapy.Methods:The effects of PET/CT were retrospectively explored on 13 R/R DLBCL patients who were treated with CAR-T therapy.Parameters reflecting tumor metabolic burden,such as metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were measured before and after CAR-T treatment.Results:Patients with larger baseline MTV or longer sum of longest diameters showed shorter overall survival(OS)time than those with low tumor burden.Patients achieved complete remission(CR),partial remission(PR)and minor remission(MR)determined by response evaluation criteria in lymphoma(RECIL)in 12 weeks showed progression-free survival and OS time superior to those of patients with no remission.In addition,it was found that 2 patients with residual masses classified as PR by contrastenhanced CT of patients were evaluated as complete metabolic response by PET/CT imaging.Conclusion:PET/CT shows a great value in the evaluation of prognosis and response in CAR-T-treated R/R DLBCL patients.