无细胞游离 DNA 动态浓度和其他变量是弥漫性大 B 细胞淋巴瘤患者嵌合抗原受体 T 细胞治疗后早期进展的预测因素。
Cell-Free DNA Dynamic Concentration and Other Variables Are Predictors of Early Progression after Chimeric Antigen Receptor T Cell Therapy in Patients with Diffuse Large B Cell Lymphoma.
机构信息
Department of Haematology, Gregorio Marañón General University Hospital, Madrid, Spain; Gregorio Marañón Health Research Institute, Madrid, Spain.
Nuclear Medicine, Gregorio Marañón General University Hospital, Madrid, Spain.
出版信息
Transplant Cell Ther. 2023 Jul;29(7):472.e1-472.e4. doi: 10.1016/j.jtct.2023.03.009. Epub 2023 Mar 14.
We propose a novel biomarker that can identify patients at high risk of early progression after chimeric antigen receptor (CAR) T cell therapy. Calculation of cell-free DNA (cfDNA) with a pre-apheresis (PA) and pre-lymphodepletion (PL) sample allows monitoring of tumor dynamics (∆cfDNA). In the present study, ∆cfDNA and other biomarkers and clinical variables were evaluated in 58 patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL). ∆cfDNA (>11 ng/mL plasma; P =.003), C-reactive protein (CRP) PL (>1.06 mg/dL; P = .004), lactate dehydrogenase (LDH) PL (>304; P = .006), disease status PL (progressive disease; P = .035) and sex (male; P = .016) were highly correlated with 1 month progression. After adjusting for ∆cfDNA, CRP PL, and LDH PL, disease status PL, and sex, ∆cfDNA remained associated with 1-month progression after CAR T cell infusion.
我们提出了一种新的生物标志物，可以识别嵌合抗原受体 (CAR) T 细胞治疗后早期进展风险较高的患者。在预采集（PA）和预淋巴细胞耗竭（PL）样本中计算游离细胞 DNA（cfDNA）可以监测肿瘤动力学（∆cfDNA）。在本研究中，对 58 例复发/难治性弥漫性大 B 细胞淋巴瘤（DLBCL）患者的 ∆cfDNA 和其他生物标志物及临床变量进行了评估。∆cfDNA（>11ng/mL 血浆；P=.003）、PL 时 C 反应蛋白（CRP）（>1.06mg/dL；P=.004）、PL 时乳酸脱氢酶（LDH）（>304；P=.006）、PL 时疾病状态（进展性疾病；P=.035）和性别（男性；P=.016）与 1 个月时的进展高度相关。在调整了 ∆cfDNA、CRP PL 和 LDH PL 后，PL 时的疾病状态和性别，∆cfDNA 与 CAR T 细胞输注后 1 个月的进展仍然相关。
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