Circulating tumor DNA in B cell lymphomas.

Purpose of review: This review evaluates the importance of circulating tumor DNA (ctDNA) as a minimally invasive tool in lymphoma management.

Recent findings: Current literature demonstrates ctDNA's ability to alleviate the shortcomings of standard biopsy and imaging, providing real-time insights into tumor burden, clonal evolution, and treatment resistance. In Hodgkin lymphoma, ctDNA allows for comprehensive genomic profiling and treatment monitoring. In diffuse large B-cell lymphoma (DLBCL), ctDNA correlates with disease burden and is valuable for tracking resistance, especially in CAR T-cell therapy. In rare subtypes like primary central nervous system lymphoma (PCNSL) and intravascular large B-cell lymphoma (IVLBCL), ctDNA enhances diagnostic precision and enables early relapse detection. Even in indolent lymphomas, ctDNA could prove useful in relapse monitoring and risk assessment.

Summary: CtDNA analysis could become a key element in personalized lymphoma management, enabling earlier interventions and tailored treatment strategies. However, future efforts should focus on harmonizing methodologies and validating findings in large-scale trials to allow these techniques to be adopted in routine practice.