ArticleFrontiers in oncology2026
Pretreatment TyG-BMI predicts CD19 CAR-T persistence and prognosis in diffuse large B-cell lymphoma.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although CD19 CAR-T cell therapy has improved outcomes in relapsed or refractory diffuse large B-cell lymphoma (DLBCL), responses are variable and predictive biomarkers are lacking. The triglyceride glucose-body mass index (TyG-BMI)-a surrogate of insulin resistance-has shown prognostic value in solid tumors, but its relevance to DLBCL and CAR-T efficacy remains unknown. Methods: We retrospectively analyzed 204 newly diagnosed DLBCL patients treated with rituximab-containing regimens, stratified by median TyG-BMI. Prognostic associations were assessed by Kaplan-Meier and multivariate Cox regression, and a nomogram was constructed. In an exploratory sub-analysis, 20 patients who received CD19 CAR-T therapy were assessed. CAR-T cell persistence was measured by flow cytometry one week post-infusion and correlated with pre-infusion TyG-BMI by Pearson analysis. CRS and ICANS were graded per ASTCT criteria. Post-CAR-T survival was compared by Kaplan-Meier analysis stratified by median pre-infusion TyG-BMI. Results: High TyG-BMI was independently associated with poorer PFS (HR, 2.146; 95% CI, 1.092-4.214; Conclusion: TyG-BMI is an independent prognostic factor in DLBCL that refines IPI-based stratification, and elevated pre-infusion TyG-BMI is associated with attenuated CAR-T cell persistence and inferior outcomes. This readily available metabolic index may aid risk assessment and treatment planning in DLBCL.
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