嵌合抗原受体（CAR）T细胞已在难治性或复发性大B细胞淋巴瘤（LBCL）的治疗中被证明是有效的。最近，sDmax作为两个最远病灶间的距离与患者体表面积标准化之间的对应项，在LBCL中作为一种预后因子出现。本研究旨在确定与CAR T细胞治疗的患者的预后和不良事件预测相关的[18F]FDG-PET生物标志物。患者是从两个不同的大学医院回顾性纳入的。他们接受CAR T细胞治疗LBCL，并在CAR T细胞输注前接受了[18F]FDG-PET。病灶被半自动地分割，阈值设为最大摄取的41％。除了临床生物学特征，还收集了sDmax、总体代谢肿瘤体积（TMTV）、SUVmax和健康淋巴器官和肝脏的摄取强度。使用卡帕兰-迈尔方法估计了无进展生存（PFS）和总体生存（OS）。报告了不良事件的发生情况，如细胞因子释放综合征（CRS）和免疫效应细胞相关的神经毒性综合征（ICANS）。共纳入了56名患者。中位随访时间为9.7个月。多变量分析表明，TMTV（截断值为36 mL）是PFS的独立预后因子（p < 0.001），而sDmax（截断值为0.15 m-1）是OS的独立预后因子（p = 0.008）。对于不良事件的发生，C-反应蛋白水平 > 35 mg/L（p = 0.006）和CAR T细胞输注前肝脏SUVmean > 2.5（p = 0.027）与2到4级CRS相关；脾脏SUVmean > 1.9与2到4级ICANS相关。TMTV和sDmax在PFS和OS上分别具有独立的预后价值。关于不良事件，肝脏和脾脏的平均摄取与2到4级CRS和ICANS的发生相关。将这些生物标志物整合到临床流程中，可有助于早期调整患者管理。© 2023年。作者（们）独家许可给斯普林格-弗拉格公司，德国，斯普林格自然出版集团的一部分。

Chimeric antigen receptor (CAR) T cells have established themselves as an effective treatment for refractory or relapsed large B cell lymphoma (LBCL). Recently, the sDmax, which corresponds to the distance separating the two farthest lesions standardized by the patient's body surface area, has appeared as a prognostic factor in LBCL. This study aimed to identify [18F]FDG-PET biomarkers associated with prognosis and predictive of adverse events in patients treated with CAR T cells.Patients were retrospectively included from two different university hospitals. They were being treated with CAR T cells for LBCL and underwent [18F]FDG-PET just before CAR T cell infusion. Lesions were segmented semi-automatically with a threshold of 41% of the maximal uptake. In addition to clinico-biological features, sDmax, total metabolic tumor volume (TMTV), SUVmax, and uptake intensity of healthy lymphoid organs and liver were collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The occurrence of adverse events, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), was reported.Fifty-six patients were included. The median follow-up was 9.7 months. Multivariate analysis showed that TMTV (cut-off of 36 mL) was an independent prognostic factor for PFS (p < 0.001) and that sDmax (cut-off of 0.15 m-1) was an independent prognostic factor for OS (p = 0.008). Concerning the occurrence of adverse events, a C-reactive protein level > 35 mg/L (p = 0.006) and a liver SUVmean > 2.5 (p = 0.027) before CAR T cells were associated with grade 2 to 4 CRS and a spleen SUVmean > 1.9 with grade 2 to 4 ICANS.TMTV and sDmax had independent prognostic values, respectively, on PFS and OS. Regarding adverse events, the mean liver and spleen uptakes were associated with the occurrence of grade 2 to 4 CRS and ICANS, respectively. Integrating these biomarkers into the clinical workflow could be useful for early adaptation of patients management.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.