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@ARTICLE{Winkelmann:306516,
      author       = {M. Winkelmann$^*$ and P. Achhammer and V. Blumenberg$^*$
                      and K. Rejeski$^*$ and V. L. Bücklein$^*$ and C. Schmidt
                      and G. T. Sheikh and M. Brendel$^*$ and J. Ricke and M. von
                      Bergwelt-Baildon$^*$ and M. Subklewe$^*$ and W. G. Kunz$^*$},
      title        = {{P}redictive value of maximum tumor dissemination ({D}max)
                      in lymphoma patients treated with {CD}19-specific {CAR}
                      {T}-{C}ells.},
      journal      = {Cancer imaging},
      volume       = {nn},
      issn         = {1470-7330},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2025-02581},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {CD19-specific chimeric antigen receptor T-cell therapy
                      (CART) has emerged as effective treatment for relapsed or
                      refractory (r/r) lymphoma. The maximum distance (Dmax) of
                      lymphoma lesions holds potential as prognostic imaging
                      biomarker in lymphoma treated with conventional therapies,
                      but evidence in the context of CART remains scarce and
                      further studies are needed to clarify its clinical
                      relevance. We evaluated Dmax at baseline imaging as a
                      potential prognostic tool for assessment of metabolic and
                      overall response, progression-free survival (PFS) and
                      overall survival (OS).Consecutive r/r lymphoma patients with
                      (PET/)CT imaging at baseline (BL) before lymphodepletion and
                      subsequent CAR T-cell transfusion were included. Dmax was
                      measured in cm at BL. Patients were divided by tertiles into
                      three equal sized groups according to Dmax. Ann Arbor stages
                      were calculated at baseline and the sum of product diameters
                      (SPD) was used to represent tumor burden (TB). Overall
                      response according to Lugano criteria and the Deauville
                      score were determined at day 90 PET/CT imaging.Thirty-nine
                      patients met the inclusion criteria. Median Dmax was 40.0 cm
                      (IQR: 16.4-70.3 cm) at BL. Median TB decreased from BL with
                      4,095 mm2 to 770 mm2 at FU imaging. Median TB at BL was
                      significantly higher in the Dmax intermediate and high group
                      compared to the Dmax low group (p = 0.005) with 7,222 mm2
                      (IQR: 3,355-11,941 mm2), 4,649 mm2 (IQR: 2,376-10,406 mm2)
                      and 1,739 mm2 (IQR: 715-7,402 mm2), respectively. Dmax
                      intermediate and high group showed significantly higher Ann
                      Arbor stages (p < 0.001). The survival analysis revealed a
                      significantly (p = 0.030) shorter PFS in the Dmax high group
                      compared to the other patients (91 vs. 364 days), but no
                      relevant differences in OS (p = 0.151).Patients with high
                      Dmax showed a shorter PFS, but no significant differences in
                      OS. Dmax is a useful parameter for characterizing tumor
                      dissemination, which could also be incorporated into scores
                      due to its interval scale.},
      keywords     = {18F-FDG PET/CT (Other) / Ann-Arbor, Deauville-Score (Other)
                      / CAR t-cell therapy (Other) / Dissemination features
                      (Other) / Dmax, Dmaxbulk (Other) / Lugano criteria (Other) /
                      Lymphoma (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41275261},
      doi          = {10.1186/s40644-025-00959-w},
      url          = {https://inrepo02.dkfz.de/record/306516},
}