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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 1/2021

Open Access 01-01-2021 | Lymphoma | Short Communication

18F-FDG PET/CT of off-target lymphoid organs in CD19-targeting chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma

Authors: Thorsten Derlin, Christian Schultze-Florey, Rudolf A. Werner, Nora Möhn, Thomas Skripuletz, Sascha David, Gernot Beutel, Matthias Eder, Tobias L. Ross, Frank M. Bengel, Arnold Ganser, Christian Koenecke

Published in: Annals of Nuclear Medicine | Issue 1/2021

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Abstract

Objective

The interplay between systemic inflammation, activity of lymphoid organs and lymphoma activity in CD19-targeting chimeric antigen receptor (CAR)-T-cell immunotherapy, and its significance for response and toxicity, is not well defined.

Methods

Using serial 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), metabolic parameters of lymphoma and lymphoid organs were analyzed in ten patients receiving Tisagenlecleucel (an autologous CD19 CAR-T cell product) for relapsed or refractory diffuse large B-cell lymphoma. The prevalence and severity of toxicity (e.g., neurotoxicity) were noted.

Results

Achieving remission required early metabolic response (P = 0.0476). Early suppression of metabolic activity of lymphoid organs (spleen, P = 0.0368; lymph nodes, P = 0.0470) was associated with poor outcome. Lymphoma metabolic activity was significantly higher in patients with neurotoxicity (P = 0.0489).

Conclusions

Early metabolic changes in lymphoma lesions and off-target lymphoid organs parallel medium-term response to CAR-T-cell therapy. PET can identify patients at risk for severe toxicity.
Appendix
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Metadata
Title
18F-FDG PET/CT of off-target lymphoid organs in CD19-targeting chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
Authors
Thorsten Derlin
Christian Schultze-Florey
Rudolf A. Werner
Nora Möhn
Thomas Skripuletz
Sascha David
Gernot Beutel
Matthias Eder
Tobias L. Ross
Frank M. Bengel
Arnold Ganser
Christian Koenecke
Publication date
01-01-2021
Publisher
Springer Singapore
Published in
Annals of Nuclear Medicine / Issue 1/2021
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-020-01544-w

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