Bridging therapy before CD19-directed chimeric antigen receptor (CAR) T-cell infusion is frequently applied in patients with relapsed or refractory Large B-cell lymphoma (r/r LBCL). This study aimed to assess the influence of quantified MATV and MATV-dynamics, between pre-apheresis (baseline) and pre-lymphodepleting chemotherapy (pre-LD) MATV, on CAR T-cell outcomes and toxicities in patients with r/r LBCL. MATVs were calculated semi-automatically at baseline (n = 74) and pre-LD (n = 68) in patients with r/r LBCL who received axicabtagene ciloleucel. At baseline, patients with a low MATV (< 190 cc) had a better time to progression (TTP) and overall survival (OS) compared to high MATV patients (p < 0.001). High MATV patients who remained stable or reduced upon bridging therapy showed a significant improvement in TTP (p = 0.041) and OS (p = 0.015), compared to patients with a high pre-LD MATV (> 480 cc). Furthermore, high MATV baseline was associated with severe cytokine release syndrome (CRS, p = 0.001). In conclusion, patients with low baseline MATV had the best TTP/OS and effective reduction or controlling MATV during bridging improved survival outcomes in patients with a high baseline MATV, providing rationale for the use of more aggressive bridging regimens.
在复发或难治性大B细胞淋巴瘤（r/r LBCL）患者中，CD19导向的嵌合抗原受体T细胞输注前的桥接治疗经常被应用。本研究旨在评估量化MATV以及MATV动态（在单采前（基线）和淋巴细胞清除化疗前之间）对r/r LBCL患者CAR T细胞疗效和毒性的影响。在接受阿基仑赛治疗的r/r LBCL患者中，半自动计算了基线（n=74）和淋巴细胞清除化疗前（n=68）的MATV。在基线时，低MATV（<190 cc）患者较高MATV患者具有更好的无进展生存时间和总生存期（p<0.001）。与淋巴细胞清除化疗前MATV高（>480 cc）的患者相比，在桥接治疗期间保持稳定或减少的高MATV患者显示出无进展生存时间（p=0.041）和总生存期（p=0.015）的显著改善。此外，高基线MATV与严重的细胞因子释放综合征相关（p=0.001）。总之，低基线MATV患者具有最佳的无进展生存时间/总生存期，而在桥接期间有效减少或控制MATV改善了高基线MATV患者的生存结局，这为使用更积极的桥接方案提供了依据。
肿瘤(癌症)患者之家