Adnan Danish, Alexandra Della Pia, Lindsay Fogel, Hassan Alkhatatneh, Charles Zhao, Tony Varughese, Karine A Al Feghali, Lauren Pascual, Brittany Sinclaire, Michael Marafelias, Joshua Zenreich, Yen-Hong Kuo, Tatyana A Feldman, Yi Zhang, Andre H Goy, Andrew Ip, Scott D Rowley
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引用次数: 0
摘要
背景和目的:本研究旨在确定复发或难治性(R/R)非霍奇金淋巴瘤(NHL)患者中符合 CD19 CAR T 细胞疗法(CART)后早期复发高风险标准且疾病可被标准放射治疗(RT)计划所涵盖(定义为材料和方法)的患者的患病率:这是一项单中心回顾性研究,研究对象为2018年至2022年接受CD19 CART治疗的R/R NHL患者。符合条件的患者均有化疗前的放射学检查。所有患者均按病灶数量和高危疾病史标准分类:大块病灶≥10厘米,≥1个结外(EN)部位,LDH≥正常,或≥1个病灶SUVmax≥10.结果:共评估了81例R/R NHL患者。根据我们的定义,40 例(49%)患者符合桥接 RT 的条件,其中 38 例符合高风险标准:31例有≥1个EN部位,19例有≥1个SUVmax≥10的病灶,16例有大块病变,3例LDH升高。CART 3 个月后,高危患者的 ORRs 与结论一致:约47%的患者(38/81)在CART后被归类为复发高风险患者,其疾病可被纳入标准放射计划,并符合桥接RT研究的条件。
Prevalence of non-Hodgkin lymphoma patients at high-risk of failure after CAR T-cell therapy eligible for bridging radiation therapy.
Background and purpose: The aim of this study was to determine the prevalence of patients with relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) meeting high-risk criteria for early relapse after CD19 CAR T-cell therapy (CART) who have disease encompassable in a standard radiation therapy (RT) plan (defined as <5 malignant lesions) and may benefit from bridging RT prior to CD19 CART.
Materials and methods: This is a single-center, retrospective study of patients with R/R NHL who received CD19 CART from 2018 to 2022. Eligible patients had pre-apheresis radiologic studies available. All patients were classified by number of lesions and history of high-risk disease criteria: bulky disease ≥10 cm, ≥1 extranodal (EN) sites, LDH ≥normal, or ≥1 lesion with SUVmax ≥10.
Results: A total of 81 patients with R/R NHL were evaluated. Based on our definition, 40 (49%) patients would have been eligible for bridging RT, including 38 patients who met high-risk criteria: 31 with ≥1 EN site, 19 had ≥1 lesion with SUVmax ≥10, 16 with bulky disease, and 3 with elevated LDH. At 3 months after CART, ORRs in high-risk patients with <5 lesions, ≥5 lesions, and no lesions on pre-apheresis studies were 76% (CR 69%, PR 7%), 70% (CR 60%, PR 10%), and 80% (CR 80%), respectively.
Conclusion: Approximately 47% (38/81) of patients were classified as at high risk of relapse after CART with disease encompassable in a standard radiation plan and eligible for bridging RT studies.
期刊介绍:
Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.