{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:19:13Z","timestamp":1787548753345,"version":"build-2736575974"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although CD19 CAR-T cell therapy has improved outcomes in relapsed or refractory diffuse large B-cell lymphoma (DLBCL), responses are variable and predictive biomarkers are lacking. The triglyceride glucose-body mass index (TyG-BMI)\u2014a surrogate of insulin resistance\u2014has shown prognostic value in solid tumors, but its relevance to DLBCL and CAR-T efficacy remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 204 newly diagnosed DLBCL patients treated with rituximab-containing regimens, stratified by median TyG-BMI. Prognostic associations were assessed by Kaplan-Meier and multivariate Cox regression, and a nomogram was constructed. In an exploratory sub-analysis, 20 patients who received CD19 CAR-T therapy were assessed. CAR-T cell persistence was measured by flow cytometry one week post-infusion and correlated with pre-infusion TyG-BMI by Pearson analysis. CRS and ICANS were graded per ASTCT criteria. Post-CAR-T survival was compared by Kaplan-Meier analysis stratified by median pre-infusion TyG-BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High TyG-BMI was independently associated with poorer PFS (HR, 2.146; 95% CI, 1.092\u20134.214;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.027) and OS (HR, 2.531; 95% CI, 1.084\u20135.913;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.032), and further stratified risk within IPI risk groups and across disease stages. A nomogram incorporating TyG-BMI, IPI, and bone marrow involvement predicted 1-, 3-, and 5-year OS (AUC: 0.886, 0.799, 0.772). In the CAR-T subcohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020), elevated pre-infusion TyG-BMI was significantly inversely correlated with CAR-T cell persistence at one week post-infusion (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0-0.570,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009). Patients with high pre-infusion TyG-BMI experienced inferior responses to CAR-T therapy, with shorter median PFS (5.0\n                      <jats:italic>vs.<\/jats:italic>\n                      19.5 months) and OS (39.0\n                      <jats:italic>vs.<\/jats:italic>\n                      81.0 months) compared with the low TyG-BMI group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TyG-BMI is an independent prognostic factor in DLBCL that refines IPI-based stratification, and elevated pre-infusion TyG-BMI is associated with attenuated CAR-T cell persistence and inferior outcomes. This readily available metabolic index may aid risk assessment and treatment planning in DLBCL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1921922","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:24:55Z","timestamp":1787545495000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pretreatment TyG-BMI predicts CD19 CAR-T persistence and prognosis in diffuse large B-cell lymphoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Zelin","family":"Liu","sequence":"first","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, 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China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Hematology, Affiliated Hospital of Jiangnan University","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keke","family":"Huang","sequence":"additional","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Liao","sequence":"additional","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linhui","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianfang","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The First Affiliated Hospital of Bengbu Medical College","place":["Bengbu, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lujie","family":"Liu","sequence":"additional","affiliation":[{"name":"Weifang Yidu Central Hospital","place":["Qingzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianshan","family":"Tao","sequence":"additional","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Department of Hematology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shudao","family":"Xiong","sequence":"additional","affiliation":[{"name":"Hematological Lab, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, 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