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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},
}