18F-F-AraG PET Imaging to Evaluate Immunological Response to CAR T Cell Therapy in Lymphoma

Inclusion Criteria:

• Age ≥ 18 years old

• Histologically confirmed aggressive B cell NHL including the following types definedby WHO 2008:

• DLBCL not otherwise specified; T cell/histiocyte rich large B cell lymphoma;DLBCL associated with chronic inflammation; Epstein Barr virus (EBV)+ DLBCL ofthe elderly; OR

• primary mediastinal (thymic) large B cell lymphoma

• transformation of follicular lymphoma, marginal zone lymphoma or chroniclymphocytic leukemia to DLBCL will also be included

• Measurable disease by PET imaging (as defined by Cheson (2014)), that meets all thefollowing criteria:

• At least one measureable lesion away from head & neck, liver, kidneys, GI tractand bladder

• At least one biopsy-accessible lesion or lymph node.

• Express willingness to undergo low risk FNA or core biopsy of subcutaneousaccessible lesion or lymph node.

• Scheduled to receive commercial or research CAR T cell therapy with axicabtageneciloleucel (Yescarta ®) as part of anticancer therapy.

• Adequate renal and hepatic function, defined as:

1. Creatinine clearance (as estimated by Cockcroft Gault) ≥ 60 mL/min or Cr < 1.6mg/dL

2. Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤ 2.5xupper limit of normal (ULN)

3. Total bilirubin ≤ 1.5 mg/dL, except in cases of Gilbert's syndrome

• Able to give informed consent. Subjects unable to give informed consent will not beeligible for this study

Exclusion Criteria:

• Women who are pregnant or breastfeeding.

• Subjects with significant GI disease involvement by PET imaging

• In the investigator's judgment, have any medical condition likely to interfere withassessment of safety or efficacy, be unable to tolerate additional radiation, or beunlikely to complete all protocol-required visits and procedures.