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.

CD19 定向嵌合抗原受体 (CAR) T 细胞输注之前的桥接治疗经常应用于复发或难治性大 B 细胞淋巴瘤 (r/r LBCL) 患者。本研究旨在评估血浆分离术前（基线）和淋巴清除化疗前（LD）MATV 之间量化的 MATV 和 MATV 动力学对 CAR T 细胞结果和复发/难治性 LBCL 患者毒性的影响。 对于接受 axicabtagene ciloleucel 治疗的 r/r LBCL 患者，半自动计算基线 ( n  = 74) 和 LD 前 ( n = 68) 的 MATV。在基线时，与高 MATV 患者相比，低 MATV (< 190 cc) 患者的进展时间 (TTP) 和总生存期 (OS) 更长 ( p  < 0.001)。 与 LD 前高 MATV (> 480 cc) 的患者相比，桥接治疗后保持稳定或降低的高 MATV 患者的TTP ( p  = 0.041) 和 OS ( p = 0.015)显着改善。此外，高 MATV 基线与严重的细胞因子释放综合征相关（CRS，p  = 0.001）。总之，低基线 MATV 的患者具有最佳的 TTP/OS，并且在桥接期间有效减少或控制 MATV 可改善高基线 MATV 患者的生存结果，为使用更积极的桥接方案提供了理由。