{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T16:03:34Z","timestamp":1781021014227,"version":"3.54.1"},"reference-count":26,"publisher":"American Society of Hematology","issue":"11","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,9]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Patients with large B-cell lymphoma who progress after second-line (2L) chimeric antigen receptor T cell (CAR T) therapy have an increasing number of post-CAR T treatment options available and should be considered for timely intervention if at high risk of CAR T failure. In this national cohort of 302 patients receiving 2L axicabtagene ciloleucel (axi-cel), we assessed the use of early fluorodeoxyglucose positron emission tomography (PET) response to guide post-CAR T management. A total of 245 patients with treatment response at 1 month were grouped according to depth of response by Deauville score (DS): complete metabolic response or focal residual activity in the bridging radiotherapy field (DS1-3\/DS4RT), partial response (PR) DS4, and PR DS5. DS response categories were significantly associated with risk of progression, progression-free survival, and overall survival. Patients with DS4 and DS5 response had a 50% and 73% risk of progression by month 6, respectively, compared with 25% for DS1-3\/DS4RT (DS4: hazard ratio [HR], 3.07 [95% CI: 1.85-5.07] and DS5: HR, 5.20 [95% CI: 2.95-9.16]; P&amp;lt; .0001), which was independently significant in multivariable analyses. In a risk model using DS categories and preinfusion lactate dehydrogenase levels \u22652 upper limit of normal, we identified a high-risk group with significant risk of early failure (HR, 5.21 [95% CI: 3.27-8.29]; P&amp;lt; .001). Our results demonstrate the prognostic value of early PET response in patients treated with 2L axi-cel, independent of preinfusion risk factors. Responding high-risk patients had \u226570% risk of progression by month 6 and should be strongly considered for early post-CAR T therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/bloodadvances.2026019802","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T20:52:44Z","timestamp":1774644764000},"page":"3777-3786","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":0,"title":["Early PET response predicts the risk of relapse after 2L axi-cel in large B-cell lymphoma"],"prefix":"10.1182","volume":"10","author":[{"given":"Andrea","family":"Kuhnl","sequence":"first","affiliation":[{"name":"1Department of Haematology, King\u2019s College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy A.","family":"Kirkwood","sequence":"additional","affiliation":[{"name":"2CR UK & University College London Cancer Trials Centre, University College London Cancer Institute, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Northend","sequence":"additional","affiliation":[{"name":"3Department of Haematology, University College London Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Alajangi","sequence":"additional","affiliation":[{"name":"4Department of Haematology, University Hospitals Bristol and Weston, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Uttenthal","sequence":"additional","affiliation":[{"name":"5Department of Haematology, Cambridge University Hospitals, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Norman","sequence":"additional","affiliation":[{"name":"6Manchester Royal Infirmary, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwai","family":"Hiew","sequence":"additional","affiliation":[{"name":"7Department of Haematology, University Hospital Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-7195","authenticated-orcid":false,"given":"Frances","family":"Seymour","sequence":"additional","affiliation":[{"name":"8Leeds Teaching Hospitals, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7064-8900","authenticated-orcid":false,"given":"Bernard D.","family":"Maybury","sequence":"additional","affiliation":[{"name":"9Department of Haematology, University Hospital Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Osborne","sequence":"additional","affiliation":[{"name":"10Department of Haematology, Freeman Hospital, Newcastle University, Newcastle, United Kingdom"},{"name":"11Department of Haematology, Newcastle University, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sillito","sequence":"additional","affiliation":[{"name":"12Department of Haematology, Royal Marsden Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5551-7416","authenticated-orcid":false,"given":"Ahmed","family":"Abdulgawad","sequence":"additional","affiliation":[{"name":"13Department of Haematology, The Christie Hospital, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceri","family":"Jones","sequence":"additional","affiliation":[{"name":"14Department of Haematology, University Hospital of Wales, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4667-7513","authenticated-orcid":false,"given":"Alison","family":"Delaney","sequence":"additional","affiliation":[{"name":"15Sheffield Teaching Hospital, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3975-2448","authenticated-orcid":false,"given":"William","family":"Townsend","sequence":"additional","affiliation":[{"name":"3Department of Haematology, University College London Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-3379","authenticated-orcid":false,"given":"Aikaterini","family":"Panopoulou","sequence":"additional","affiliation":[{"name":"16Department of Haematology, Oxford University Hospitals, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8505-7430","authenticated-orcid":false,"given":"John G.","family":"Gribben","sequence":"additional","affiliation":[{"name":"17Barts Cancer Institute, Queen Mary University of London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Bataillard","sequence":"additional","affiliation":[{"name":"18Imperial College Healthcare NHS Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5826-6675","authenticated-orcid":false,"given":"Amrith","family":"Mathew","sequence":"additional","affiliation":[{"name":"9Department of Haematology, University Hospital Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-9464","authenticated-orcid":false,"given":"Nicolas","family":"Martinez-Calle","sequence":"additional","affiliation":[{"name":"19Department of Haematology, Nottingham University Hospital, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavanya","family":"Gajendran","sequence":"additional","affiliation":[{"name":"20Department of Haematology, St George\u2019s University Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7517-6938","authenticated-orcid":false,"given":"Andrew J.","family":"Davies","sequence":"additional","affiliation":[{"name":"21Department of Medical Oncology, University Hospital Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikesh","family":"Chavda","sequence":"additional","affiliation":[{"name":"4Department of Haematology, University Hospitals Bristol and Weston, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7580-4482","authenticated-orcid":false,"given":"Emil","family":"Kumar","sequence":"additional","affiliation":[{"name":"1Department of Haematology, King\u2019s College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4915-2833","authenticated-orcid":false,"given":"Robin","family":"Sanderson","sequence":"additional","affiliation":[{"name":"1Department of Haematology, King\u2019s College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Kamat","sequence":"additional","affiliation":[{"name":"22Department of Nuclear Medicine, King's College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Petrides","sequence":"additional","affiliation":[{"name":"23Department of Nuclear Medicine, Freeman Hospital, Newcastle University, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-5858","authenticated-orcid":false,"given":"Claire","family":"Roddie","sequence":"additional","affiliation":[{"name":"3Department of Haematology, University College London Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Menne","sequence":"additional","affiliation":[{"name":"10Department of Haematology, Freeman Hospital, Newcastle University, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridhar","family":"Chaganti","sequence":"additional","affiliation":[{"name":"9Department of Haematology, University Hospital Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"issue":"5","key":"2026060911323729600_bib1","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1002\/hem3.62","article-title":"Treatment outcomes in patients with large B-cell lymphoma after progression to chimeric antigen receptor T-cell therapy","volume":"8","author":"Iacoboni","year":"2024","journal-title":"HemaSphere"},{"issue":"suppl 1","key":"2026060911323729600_bib2","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1182\/blood-2021-150994","article-title":"Outcome of relapsed\/refractory aggressive B-cell lymphoma patients relapsing after anti-CD19 CAR T-cells and enrolled in the Descar-T French National Registry","volume":"138","author":"Di Blasi","year":"2021","journal-title":"Blood"},{"issue":"1","key":"2026060911323729600_bib3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1182\/bloodadvances.2025016968","article-title":"Outcomes of bispecific antibodies after CAR T-cell failure for large B-cell lymphoma: results from the ABC consortium","volume":"10","author":"Melody","year":"2026","journal-title":"Blood Adv"},{"issue":"1","key":"2026060911323729600_bib4","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1182\/bloodadvances.2021005807","article-title":"Early FDG-PET response predicts CAR-T failure in large B-cell lymphoma","volume":"6","author":"Kuhnl","year":"2022","journal-title":"Blood Adv vol"},{"issue":"12","key":"2026060911323729600_bib5","doi-asserted-by":"crossref","first-page":"3433","DOI":"10.3324\/haematol.2022.282345","article-title":"Prognostic value of early positron emission tomography in patients with large B-cell lymphoma treated with anti-CD19 chimeric antigen receptor T-cell therapy","volume":"108","author":"Crombie","year":"2023","journal-title":"Haematologica"},{"issue":"1","key":"2026060911323729600_bib6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3324\/haematol.2021.280550","article-title":"Positron emission tomography-imaging assessment for guiding strategy in patients with relapsed\/refractory large B-cell lymphoma receiving CAR T cells","volume":"108","author":"Galtier","year":"2023","journal-title":"Haematologica"},{"key":"2026060911323729600_bib7","doi-asserted-by":"crossref","DOI":"10.1002\/hem3.70312","article-title":"Outcomes of second-line axicabtagene ciloleucel for large B-cell lymphoma in the UK","author":"Kuhnl","year":"2026","journal-title":"HemaSphere"},{"issue":"4","key":"2026060911323729600_bib8","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.bbmt.2018.12.758","article-title":"ASTCT Consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells","volume":"25","author":"Lee","year":"2019","journal-title":"Biol Blood Marrow Transpl"},{"issue":"27","key":"2026060911323729600_bib9","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1200\/JCO.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J Clin Oncol"},{"issue":"11","key":"2026060911323729600_bib10","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.3324\/haematol.2023.283311","article-title":"Consolidative radiotherapy for residual FDG activity on day +30 post CAR T-cell therapy in non-Hodgkin lymphoma","volume":"108","author":"Saifi","year":"2023","journal-title":"Haematologica"},{"issue":"1","key":"2026060911323729600_bib11","doi-asserted-by":"crossref","first-page":"S152","DOI":"10.1016\/j.ijrobp.2025.06.1244","article-title":"Updated results of RESTART protocol (RadiothErapy bridging and conSolidaTion for CAR-T) in large B-cell lymphoma","volume":"123","author":"Mikhaeel","year":"2025","journal-title":"Int J Radiat Oncol"},{"issue":"21","key":"2026060911323729600_bib12","doi-asserted-by":"crossref","first-page":"6710","DOI":"10.1182\/bloodadvances.2023010665","article-title":"Inflammatory reactions mimic residual or recurrent lymphoma on [18F]FDG-PET\/CT after CD19-directed CAR T-cell therapy","volume":"7","author":"de Boer","year":"2023","journal-title":"Blood Adv"},{"issue":"27","key":"2026060911323729600_bib13","doi-asserted-by":"crossref","first-page":"3034","DOI":"10.1200\/JCO.21.00377","article-title":"Monitoring of circulating tumor DNA improves early relapse detection after axicabtagene ciloleucel infusion in large B-cell lymphoma: results of a prospective multi-institutional trial","volume":"39","author":"Frank","year":"2021","journal-title":"J Clin Oncol"},{"issue":"16","key":"2026060911323729600_bib14","doi-asserted-by":"crossref","first-page":"4608","DOI":"10.1182\/bloodadvances.2022009426","article-title":"Circulating tumor DNA adds specificity to PET after axicabtagene ciloleucel in large B-cell lymphoma","volume":"7","author":"Dean","year":"2023","journal-title":"Blood Adv"},{"issue":"suppl 1","key":"2026060911323729600_bib15","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1182\/blood-2023-181007","article-title":"Circulating tumor DNA dynamics as early outcome predictors for lisocabtagene maraleucel as second-line therapy for large B-cell lymphoma from the phase 3 TRANSFORM study","volume":"142","author":"Stepan","year":"2023","journal-title":"Blood"},{"issue":"1","key":"2026060911323729600_bib16","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s13045-022-01256-w","article-title":"Metabolic characteristics and prognostic differentiation of aggressive lymphoma using one-month post-CAR-T FDG PET\/CT","volume":"15","author":"Breen","year":"2022","journal-title":"J Hematol Oncol"},{"issue":"9","key":"2026060911323729600_bib17","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1182\/bloodadvances.2021006715","article-title":"Day 30 SUVmax predicts progression in patients with lymphoma achieving PR\/SD after CAR T-cell therapy","volume":"6","author":"Al Zaki","year":"2022","journal-title":"Blood Adv"},{"issue":"suppl 1","key":"2026060911323729600_bib18","doi-asserted-by":"crossref","first-page":"3876","DOI":"10.1182\/blood-2021-154225","article-title":"Imaging biomarkers to predict outcomes in patients with large B-cell lymphoma with a day 28 partial response by PET\/CT imaging following CAR-T therapy","volume":"138","author":"Lutfi","year":"2021","journal-title":"Blood"},{"issue":"1","key":"2026060911323729600_bib19","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s40644-025-00888-8","article-title":"Prognostic value of early post-treatment (18)F-FDG PET\/CT in diffuse large B-cell lymphoma patients receiving chimeric antigen receptor T-cell therapy","volume":"25","author":"Mirshahvalad","year":"2025","journal-title":"Cancer Imaging"},{"issue":"3","key":"2026060911323729600_bib20","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s00259-021-05551-5","article-title":"[18F]FDG PET-CT in patients with DLBCL treated with CAR-T cell therapy: a practical approach of reporting pre- and post-treatment studies","volume":"49","author":"Cohen","year":"2022","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"2","key":"2026060911323729600_bib21","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1002\/cncr.34532","article-title":"Combination of Deauville score and quantitative positron emission tomography parameters as a predictive tool of anti-CD19 chimeric antigen receptor T-cell efficacy","volume":"129","author":"Guidetti","year":"2023","journal-title":"Cancer"},{"key":"2026060911323729600_bib22","doi-asserted-by":"crossref","first-page":"1424269","DOI":"10.3389\/fimmu.2024.1424269","article-title":"The prognostic utility of (18)F-FDG PET parameters in lymphoma patients under CAR-T-cell therapy: a systematic review and meta-analysis","volume":"15","author":"Al-Ibraheem","year":"2024","journal-title":"Front Immunol"},{"issue":"suppl 1","key":"2026060911323729600_bib23","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1182\/blood-2022-158492","article-title":"Association of metabolic tumor volume (MTV) and clinical outcomes in second-line (2L) relapsed\/refractory (R\/R) large B-cell lymphoma (LBCL) following axicabtagene ciloleucel (axi-cel) versus standard-of-care (SOC) therapy in ZUMA-7","volume":"140","author":"Locke","year":"2022","journal-title":"Blood"},{"issue":"22","key":"2026060911323729600_bib24","doi-asserted-by":"crossref","first-page":"5607","DOI":"10.1182\/bloodadvances.2020003001","article-title":"Predictive factors of early progression after CAR T-cell therapy in relapsed\/refractory diffuse large B-cell lymphoma","volume":"4","author":"Vercellino","year":"2020","journal-title":"Blood Adv"},{"issue":"14","key":"2026060911323729600_bib25","doi-asserted-by":"crossref","first-page":"3268","DOI":"10.1182\/bloodadvances.2020001900","article-title":"High metabolic tumor volume is associated with decreased efficacy of axicabtagene ciloleucel in large B-cell lymphoma","volume":"4","author":"Dean","year":"2020","journal-title":"Blood Adv"},{"issue":"9","key":"2026060911323729600_bib26","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1007\/s00277-021-04560-6","article-title":"Prognostic impact of total metabolic tumor volume in large B-cell lymphoma patients receiving CAR T-cell therapy","volume":"100","author":"Iacoboni","year":"2021","journal-title":"Ann Hematol"}],"container-title":["Blood Advances"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ashpublications.org\/bloodadvances\/article-pdf\/10\/11\/3777\/2523387\/blooda_adv-2026-019802-main.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ashpublications.org\/bloodadvances\/article-pdf\/10\/11\/3777\/2523387\/blooda_adv-2026-019802-main.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:32:45Z","timestamp":1781019165000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/bloodadvances\/article\/10\/11\/3777\/567466\/Early-PET-response-predicts-the-risk-of-relapse"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,6,9]]}},"URL":"https:\/\/doi.org\/10.1182\/bloodadvances.2026019802","relation":{},"ISSN":["2473-9529","2473-9537"],"issn-type":[{"value":"2473-9529","type":"print"},{"value":"2473-9537","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6,9]]},"published":{"date-parts":[[2026,5,27]]}}}