[Clinical Applications of Circulating Tumor DNA in Response Evaluation and Relapse Monitoring of Primary Mediastinal Large B-Cell Lymphoma].

Q4 Medicine

中国实验血液学杂志 Pub Date : 2025-04-01 DOI:10.19746/j.cnki.issn.1009-2137.2025.02.014

Lu Pan, Xin-Miao Jiang, Yan Teng, Ning Wang, Ling Huang, Han-Guo Guo, Si-Chu Liu, Xiao-Juan Wei, Fei-Li Chen, Zhan-Li Liang, Wen-Yu Li

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引用次数: 0

Abstract

Objective: To explore the clinical significance of circulating tumor DNA (ctDNA) in response evaluation and relapse monitoring for patients with primary mediastinal large B-cell lymphoma (PMBCL).

Methods: The clinical characteristics, efficacy and survival of 38 PMBCL patients in our hospital from January 2010 to April 2020 were retrospectively analyzed. The ctDNA monitoring was conducted by targeted next-generation sequencing (NGS).

Results: Among the 38 patients, 26 cases were female, and 32 cases were diagnosed with Ann Arbor stage I-II. The 5-year overall survival (OS) rate and progression-free survival (PFS) rate were 74.7% and 61.7%, respectively. Males and those with high aaIPI scores (3 points) had a relatively poor prognosis. The NGS results of 23 patients showed that STAT6 (65.2%), SOCS1 (56.5%), and TNFAIP3 (56.5%) were the most common mutated genes. Patients with stable disease (SD)/progressive disease (PD) exhibited enrichment in cell cycle, FoxO, and TNF signaling pathways. A total of 29 patients underwent end-of-treatment PET/CT (EOT PET/CT), and 16 of them received ctDNA monitoring with 12 negative. Among 6 patients with EOT PET/CT positive (Deauville 4), 4 underwent ctDNA monitoring, and 3 of them were negative, being still in continuous remission without any subsequent anti-tumor therapy.

Conclusion: CtDNA may be combined with PET/CT to assess efficacy, monitor relapse, and guide treatment of PMBCL.

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[循环肿瘤DNA在原发性纵隔大b细胞淋巴瘤疗效评价及复发监测中的临床应用]。

目的：探讨循环肿瘤DNA （ctDNA）在原发性纵隔大b细胞淋巴瘤（PMBCL）疗效评价和复发监测中的临床意义。方法：回顾性分析2010年1月~ 2020年4月我院收治的38例PMBCL患者的临床特点、疗效及生存期。ctDNA监测采用靶向下一代测序（NGS）进行。结果：38例患者中，女性26例，32例诊断为Ann Arbor I-II期。5年总生存率（OS）和无进展生存率（PFS）分别为74.7%和61.7%。男性及aaIPI评分高（3分）者预后相对较差。23例患者的NGS结果显示，STAT6（65.2%）、SOCS1（56.5%）和TNFAIP3（56.5%）是最常见的突变基因。稳定性疾病(SD)/进行性疾病（PD）患者表现出细胞周期、FoxO和TNF信号通路的富集。29例患者接受治疗末PET/CT （EOT PET/CT）检查，其中16例患者接受ctDNA监测，12例患者ctDNA阴性。6例EOT PET/CT阳性患者（Deauville 4）中，4例进行了ctDNA监测，其中3例为阴性，仍处于持续缓解期，未进行后续抗肿瘤治疗。结论：CtDNA联合PET/CT可评价PMBCL的疗效，监测复发情况，指导治疗。

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