Cancer treatment and research communications · 2025
Impact of spleen volume and volume change in non-Hodgkin lymphoma treated with chimeric antigen receptor t-cell therapy.
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Quell Christina, Kunz Wolfgang G, Blumenberg Viktoria, Rejeski Kai, Bücklein Veit L, Ingenerf Maria, Schmidt Christian, Sheikh Gabriel T, Brendel Matthias, Ricke Jens, von Bergwelt-Baildon Michael, Subklewe Marion, Winkelmann Michael
Аннотация
PURPOSE: Chimeric antigen receptor T-cell (CART) therapy targeting CD19 is effective for relapsed/refractory (r/r) lymphoma. As part of the lymphatic system, the spleen might influence CART outcomes. We examined how spleen volume (SV) and its changes affect progression-free (PFS) and overall survival (OS).
METHODS: Patients with baseline (BL) and 30-day follow-up (FU1) (PET)/CT scans were included. Spleens were 3D-segmented, and volume change (SVC) from BL to FU1 was calculated. Treatment response, overall response rate, and PFS were evaluated by Lugano criteria.
RESULTS: Among 68 patients, responders had a significantly greater SVC decrease from BL to FU1 than non-responders (p = 0.001). Those with baseline splenic involvement (SIBL) showed a smaller, non-significant SVCBL to FU1 decrease (p = 0.056). Survival analysis showed significant differences in OS (167 vs. 390 days, p = 0.040) and PFS (79 vs. 327 days, p = 0.008) based on median SVCBL to FU1. In combination with SIBL, SVC was significantly associated with PFS (p = 0.049), but not OS.
CONCLUSION: This study demonstrated that the early change in SV is associated with PFS and OS, regardless of splenic involvement and should be explored as a potential novel dynamic biomarker in the context of lymphoma patients receiving CART.
METHODS: Patients with baseline (BL) and 30-day follow-up (FU1) (PET)/CT scans were included. Spleens were 3D-segmented, and volume change (SVC) from BL to FU1 was calculated. Treatment response, overall response rate, and PFS were evaluated by Lugano criteria.
RESULTS: Among 68 patients, responders had a significantly greater SVC decrease from BL to FU1 than non-responders (p = 0.001). Those with baseline splenic involvement (SIBL) showed a smaller, non-significant SVCBL to FU1 decrease (p = 0.056). Survival analysis showed significant differences in OS (167 vs. 390 days, p = 0.040) and PFS (79 vs. 327 days, p = 0.008) based on median SVCBL to FU1. In combination with SIBL, SVC was significantly associated with PFS (p = 0.049), but not OS.
CONCLUSION: This study demonstrated that the early change in SV is associated with PFS and OS, regardless of splenic involvement and should be explored as a potential novel dynamic biomarker in the context of lymphoma patients receiving CART.