医学
淋巴瘤
放射治疗
氟脱氧葡萄糖
核医学
内科学
正电子发射断层摄影术
微小残留病
总体生存率
非霍奇金淋巴瘤
无进展生存期
弥漫性大B细胞淋巴瘤
胃肠病学
白血病
作者
Omran Saifi,William Breen,Scott C. Lester,William G. Rule,Bradley J. Stish,Allison C. Rosenthal,Javier Muñoz,Yi Lin,Radhika Bansal,Matthew Hathcock,Patrick B. Johnston,Stephen M. Ansell,Jonas Paludo,Arushi Khurana,José C. Villasboas,Yucai Wang,Madiha Iqbal,Muhamad Alhaj Moustafa,Hemant S. Murthy,Mohamed A. Kharfan‐Dabaja,Jennifer Peterson,B.S. Hoppe
出处
期刊:Haematologica
[Ferrata Storti Foundation]
日期:2023-06-15
卷期号:108 (11): 2982-2992
被引量:2
标识
DOI:10.3324/haematol.2023.283311
摘要
Majority of non-Hodgkin lymphoma (NHL) patients who achieve partial response (PR) or stable disease (SD) to CAR T-cell therapy (CAR T) on day +30 progress and only 30% achieve spontaneous complete response (CR). This study is the first to evaluate the role of consolidative radiotherapy (cRT) for residual fluorodeoxyglucose (FDG) activity on day +30 post- CAR T in NHL. We retrospectively reviewed 61 patients with NHL who received CAR T and achieved PR or SD on day +30. Progression-free survival (PFS), overall survival (OS), and local relapse-free survival (LRFS) were assessed from CAR T infusion. cRT was defined as comprehensive - treated all FDG-avid sites - or focal. Following day +30 positron emission tomography scan, 45 patients were observed and 16 received cRT. Fifteen (33%) observed patients achieved spontaneous CR, and 27 (60%) progressed with all relapses involving initial sites of residual FDG activity. Ten (63%) cRT patients achieved CR, and four (25%) progressed with no relapses in the irradiated sites. The 2-year LRFS was 100% in the cRT sites and 31% in the observed sites (P<0.001). The 2-year PFS was 73% and 37% (P=0.025) and the 2-year OS was 78% and 43% (P=0.12) in the cRT and observation groups, respectively. Patients receiving comprehensive cRT (n=13) had superior 2- year PFS (83% vs. 37%; P=0.008) and 2-year OS (86% vs. 43%; P=0.047) compared to observed or focal cRT patients (n=48). NHL patients with residual FDG activity following CAR T are at high risk of local progression. cRT for residual FDG activity on day +30 post-CAR T appears to alter the pattern of relapse and improve LRFS and PFS.
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