18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Following Chimeric Antigen Receptor T-cell Therapy in Large B-cell Lymphoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-07-06

AUTHORS

Andrew Ruff, Hatcher J. Ballard, Austin R. Pantel, Esin C. Namoglu, Mitchell E. Hughes, Sunita D. Nasta, Elise A. Chong, Adam Bagg, Marco Ruella, Michael D. Farwell, Jakub Svoboda, Mark A. Sellmyer

ABSTRACT

Purpose18F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is a well-established imaging modality to assess responses in patients with B-cell neoplasms. However, there is limited information about the utility of FDG PET/CT after chimeric antigen receptor T-cell (CART) therapies for large B-cell lymphomas. In this retrospective analysis, we aimed to evaluate how FDG PET/CT performs in patients receiving commercially available anti-CD19 CART therapies for relapsed/refractory (r/r) large B-cell lymphomas. In addition, we examined the time to repeat scan and the rate of pseudoprogression within this population. Lastly, the rates of radiographic response to CART therapy using FDG PET/CT are reported.ProceduresThe pre-treatment and post-treatment scans were analyzed from a selected cohort of 43 patients from a single institution. Patients were stratified by diagnosis of either a first occurrence of diffuse large B-cell lymphoma: de novo diffuse large B-cell lymphoma (DLBCL); or a transformed diffuse large B-cell lymphoma arising from indolent non-Hodgkin lymphoma (t-iNHL).ResultsMore patients received CART therapy for DLBCL than t-iNHL (65 % vs 35 %). FDG PET/CT had a 99 % sensitivity and 100 % specificity for detecting recurrent disease in this group. The median time to initial response assessment was 86 days (IQR 79–91; full range 24–146) after infusion. There were no biopsy-proven cases of pseudoprogression identified. In this selected group of patients, the overall response rate by Lugano 2014 criteria was 56 %. All patients with a partial response (N = 6) eventually progressed despite additional therapy.ConclusionsDue to its excellent test characteristics and ability to detect asymptomatic disease, routine surveillance with PET/CT at 3 months after CART infusion is supported by our data. Earlier PET/CT may be of value in select situations as we did not find any cases of pseudoprogression. More... »

PAGES

818-826

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11307-021-01627-8

DOI

http://dx.doi.org/10.1007/s11307-021-01627-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1139457249

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34231105


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97 retrospective analysis
98 routine surveillance
99 scans
100 select situations
101 sensitivity
102 single institution
103 situation
104 specificity
105 surveillance
106 test characteristics
107 therapy
108 time
109 tomography
110 tomography/
111 utility
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