{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:38:37Z","timestamp":1787585917270,"version":"build-2736575974"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:00:00Z","timestamp":1726272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:00:00Z","timestamp":1726272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Biomark Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chimeric antigen receptor T (CAR-T) cell therapy has greatly improved the prognosis of relapsed and refractory patients with large B-cell lymphoma (LBCL). Early identification and intervention of patients who may respond poorly to CAR-T cell therapy will help to improve the efficacy. Ninety patients from a Chinese cohort who received CAR-T cell therapy and underwent 18F-fluorodeoxyglucose positron emission tomography\/computed tomography (18F-FDG PET\/CT) scans at the screening stage (median time to infusion 53.5 days, range 27\u2013176 days), 1\u00a0month and 3\u00a0months after CAR-T cell infusion were analyzed, with RNA-sequencing conducted on 47 patients at the screening stage. Patients with maximum diameter of the largest lesion (Dmax)\u2009&lt;\u20096\u00a0cm (<jats:italic>N<\/jats:italic>\u2009=\u200960) at screening stage showed significantly higher 3-month complete response rate (85.0% vs. 33.3%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), progression-free survival (HR 0.17; 95% CI 0.08\u20130.35, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and overall survival (HR 0.18; 95% CI 0.08\u20130.40, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than those with Dmax\u2009\u2265\u20096\u00a0cm (<jats:italic>N<\/jats:italic>\u2009=\u200930). Besides, at the screening stage, Dmax combined with extranodal involvement was more efficient in distinguishing patient outcomes. The best cut-off values for total metabolic tumor volume (tMTV) and total lesion glycolysis (tTLG) at the screening stage were 50cm<jats:sup>3<\/jats:sup> and 500\u00a0g, respectively. A prediction model combining maximum standardized uptake value (SUVmax) at 1\u00a0month after CAR-T cell therapy (M1) and tTLG clearance rate was established to predict early progression for partial response\/stable disease patients evaluated at M1 after CAR-T cell therapy and validated in Lyon cohort. Relevant association of the distance separating the two farthest lesions, standardized by body surface area to the severity of neurotoxicity (AUC\u2009=\u20090.74; <jats:italic>P<\/jats:italic>\u2009=\u20090.034; 95% CI, 0.578\u20130.899) after CAR-T cell therapy was found in patients received axicabtagene ciloleucel. In patients with Dmax\u2009\u2265\u20096\u00a0cm, RNA-sequencing analysis conducted at the screening stage showed enrichment of immunosuppressive-related biological processes, as well as increased M2 macrophages, cancer-associated fibroblasts, myeloid-derived suppressor cells, and intermediate exhausted T cells. Collectively, immunosuppressive tumor microenvironment may serve as a negative prognostic indicator in patients with high tumor burden who respond poorly to CAR-T cell therapy.<\/jats:p>","DOI":"10.1186\/s40364-024-00650-5","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T23:03:30Z","timestamp":1726268610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["18F-FDG PET\/CT metrics-based stratification of large B-cell lymphoma receiving CAR-T cell therapy: immunosuppressive tumor microenvironment as a negative prognostic indicator in patients with high tumor burden"],"prefix":"10.1186","volume":"12","author":[{"given":"Ling-Shuang","family":"Sheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-Xun","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Lun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Xu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Peng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Bachy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Sesques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Jacquet-Francillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Feng","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Li","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,14]]},"reference":[{"issue":"19","key":"650_CR1","first-page":"2307","volume":"141","author":"SS Neelapu","year":"2023","unstructured":"Neelapu SS, Jacobson CA, Ghobadi A, Miklos DB, Lekakis LJ, Oluwole OO, et al. Five-year follow-up of ZUMA-1 supports the curative potential of axicabtagene ciloleucel in refractory large B-cell lymphoma. Blood. 2023;141(19):2307\u201315.","journal-title":"Blood"},{"issue":"1","key":"650_CR2","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13045-024-01540-x","volume":"17","author":"D Leithner","year":"2024","unstructured":"Leithner D, Flynn JR, Devlin SM, Mauguen A, Fei T, Zeng S, et al. Conventional and novel [(18)F]FDG PET\/CT features as predictors of CAR-T cell therapy outcome in large B-cell lymphoma. J Hematol Oncol. 2024;17(1):21.","journal-title":"J Hematol Oncol"},{"key":"650_CR3","doi-asserted-by":"crossref","unstructured":"Gui J, Li M, Xu J, Zhang X, Mei H, Lan X. [18F]FDG PET\/CT for prognosis and toxicity prediction of diffuse large B-cell lymphoma patients with chimeric antigen receptor T-cell therapy. Eur J Nucl Med Mol Imaging. 2024;51:2308\u201319.\u00a0","DOI":"10.1007\/s00259-024-06667-0"},{"issue":"8","key":"650_CR4","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1097\/RLU.0000000000003756","volume":"46","author":"P Sesques","year":"2021","unstructured":"Sesques P, Tordo J, Ferrant E, Safar V, Wallet F, Dhomps A, et al. Prognostic Impact of 18F-FDG PET\/CT in Patients With Aggressive B-Cell Lymphoma Treated With Anti-CD19 Chimeric Antigen Receptor T Cells. Clin Nucl Med. 2021;46(8):627\u201334.","journal-title":"Clin Nucl Med"},{"issue":"1","key":"650_CR5","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13045-022-01256-w","volume":"15","author":"WG Breen","year":"2022","unstructured":"Breen WG, Hathcock MA, Young JR, Kowalchuk RO, Bansal R, Khurana A, et al. Metabolic characteristics and prognostic differentiation of aggressive lymphoma using one-month post-CAR-T FDG PET\/CT. 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