QUANTITATIVE WHOLE‐BODY MRI FOR PREDICTING TREATMENT OUTCOME IN PEDIATRIC PATIENTS WITH AGGRESSIVE NON‐HODGKIN LYMPHOMA UNDERGOING CHIMERIC ANTIGEN RECEPTOR T CELL THERAPY

Abstract

Introduction: Chimeric antigen receptor (CAR) T cell therapy has shown great promise in treating pediatric patients with aggressive non-Hodgkin lymphoma (NHL), but its effectiveness can vary greatly among individuals. Accurate prediction of treatment response can aid in patient selection and treatment planning. Quantitative whole-body diffusion-weighted MRI (WB-DW MRI) has emerged as a potential tool for predicting treatment response in various types of cancer, but its predictive value for CAR-T cell therapy in pediatric patients with aggressive NHL has not been fully explored. This prospective multicenter study aimed to investigate the predictive value of quantitative whole-body diffusion-weighted MRI in this patient population. Methods: Thirty-six pediatric patients with aggressive NHL who underwent CAR T cell therapy were enrolled from three participating centers. All patients underwent WB-DW MRI before and after CAR T cell therapy. T2 values, apparent diffusion coefficient (ADC) values, and the ADC change between baseline and within 15 days after infusion were calculated. Patients were categorized into good outcome (complete remission) and poor outcome (progressive or recurrent disease) groups based on their treatment response. Receiver operating characteristic (ROC) curve analysis was used to evaluate the correlation between ADC values and treatment outcome. Results: The mean age of patients was 11 years, with 31 males. The mean change in ADC value between baseline and within 15 days after infusion was significantly higher in the good outcome group compared to the poor outcome group (p < 0.01). The change in ADC value was an independent predictor of treatment outcome on logistic regression analysis after adjusting for age, gender, and disease stage (odds ratio: 1.017; 95% confidence interval: 1.003–1.030; p < 0.01). The area under the ROC curve for ADC change was 0.794 (95% confidence interval: 0.649–0.939). Keywords: cellular therapies, immunotherapy, Imaging and Early Detection - Other No conflicts of interests pertinent to the abstract.