PMC8481921_01
FDG PET imaging patient 1. (A) Relapse 6 months after the therapy with CAR T-cells (prior to Pola-BR). (B) Complete metabolic remission after three courses of Pola-BR. (C) Confirmed complete metabolic remission 12 weeks after alloHSCT.
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FDG PET CT 6 months after infusion demonstrated a pathological uptake in pleural effusion and lymph node mediastinal, at the liver hilus, and infradiaphragmal paraaortal, as well as in the spleen, and the left adrenal gland (Figure 1A). Flow cytometry of pleural effusion confirmed the relapse and positivity for both CD19 and CD79b. We initiated a salvage therapy with a total of three cycles of Pola-BR (rituximab 375 mg/m2, polatuzumab vedotin 1.8 mg/kg, Bendamustine 90 mg/m2), resulting in a complete metabolic remission (Figure 1B). The FDG PET CT performed 12 weeks after alloHSCT showed complete metabolic remission (Figure 1C).
PMC8481921_02
FDG PET imaging patient 2. (A) Relapse seven months after the therapy with CAR T-cells (prior to Pola-BR). (B) Complete metabolic remission after three courses of Pola-BR. (C) Confirmed complete metabolic remission 52 days after alloHSCT.
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T-cells displayed a relapse on multiple localizations with increased glucose metabolism (Deauville score 5) in lymph nodes mediastinal, at the left lung hilus and in a bulky lesion in the left upper abdomen (Figure 2A). The bone marrow examination showed no infiltration. The FDG PET after three courses showed a complete metabolic remission (Figure 2B). The FDG PET CT 133 days afterward confirmed the metabolic complete remission (Figure 2C).