1. Clinical implications of CSF-ctDNA positivity in newly diagnosed diffuse large B cell lymphoma
- Author
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Liang, Jin-Hua, Wu, Yi-Fan, Shen, Hao-Rui, Li, Yue, Liang, Jun-Heng, Gao, Rui, Hua, Wei, Shang, Chun-Yu, Du, Kai-Xin, Xing, Tong-Yao, Zhang, Xin-Yu, Wang, Chen-Xuan, Zhu, Liu-Qing, Shao, Yang W., Li, Jian-Yong, Wu, Jia-Zhu, Yin, Hua, Wang, Li, and Xu, Wei
- Abstract
The clinical implications of CSF-ctDNA positivity in newly diagnosed diffuse large B cell lymphoma (ND-DLBCL) remains largely unexplored. One hundred ND-DLBCL patients were consecutively enrolled as training cohort and another 26 ND-DLBCL patients were prospectively enrolled in validation cohort. CSF-ctDNA positivity (CSF(+)) was identified in 25 patients (25.0%) in the training cohort and 7 patients (26.9%) in the validation cohort, extremely higher than CNS involvement rate detected by conventional methods. Patients with mutations of CARD11, JAK2, ID3, and PLCG2were more predominant with CSF(+) while FAT4mutations were negatively correlated with CSF(+). The downregulation of PI3K-AKT signaling, focal adhesion, actin cytoskeleton, and tight junction pathways were enriched in CSF(+) ND-DLBCL. Furthermore, pretreatment CSF(+) was significantly associated with poor outcomes. Three risk factors, including high CSF protein level, high plasma ctDNA burden, and involvement of high-risk sites were used to predict the risk of CSF(+) in ND-DLBCL. The sensitivity and specificity of pretreatment CSF-ctDNA to predict CNS relapse were 100% and 77.3%. Taken together, we firstly present the prevalence and the genomic and transcriptomic landscape for CSF-ctDNA(+) DLBCL and highlight the importance of CSF-ctDNA as a noninvasive biomarker in detecting and monitoring of CSF infiltration and predicting CNS relapse in DLBCL.
- Published
- 2024
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