Spina Valeria, Rossi Davide
Haematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland / Institute of Oncology Research, Bellinzona, Switzerland.
Swiss Med Wkly. 2019 Jan 23;149:w14709. doi: 10.4414/smw.2019.14709. eCollection 2019 Jan 14.
In the era of personalised medicine, genetic information is critical to directing therapeutic options, aiding risk stratification and disease monitoring of lymphomas. Liquid biopsy is a novel noninvasive, real-time and tumour-specific technique, reliably reflecting the comprehensive tumour genetic profile, and thus holds great promise for the genetic assessment, response monitoring and relapse detection of lymphomas. Standard methods for disease response assessment in patients with lymphoma, including positron emission tomography, are imperfect. In other haematological malignancies, particularly leukaemias, the ability to detect minimal residual disease (MRD) is increasingly influencing treatment paradigms. However, in some subtypes of lymphoma, such as diffuse large B-cell lymphoma and classic Hodgkin’s lymphoma, the application of MRD assessment techniques such as flow cytometry or polymerase chain reaction-based methods has been challenged by the absence of circulating disease. The review summarises the applications of liquid biopsy in the assessment of tumour burden and response to therapy, noninvasive genomic profiling, and monitoring of clonal dynamics in patients with diffuse large B-cell lymphoma and classic Hodgkin’s lymphoma.
在个性化医疗时代，基因信息对于指导淋巴瘤的治疗选择、辅助风险分层及疾病监测至关重要。液体活检是一种新型的非侵入性、实时且针对肿瘤的技术，能可靠地反映肿瘤的综合基因图谱，因此在淋巴瘤的基因评估、疗效监测及复发检测方面极具前景。淋巴瘤患者疾病反应评估的标准方法，包括正电子发射断层扫描，并不完善。在其他血液系统恶性肿瘤，尤其是白血病中，检测微小残留病（MRD）的能力对治疗模式的影响日益增大。然而，在某些淋巴瘤亚型中，如弥漫性大B细胞淋巴瘤和经典霍奇金淋巴瘤，由于缺乏循环疾病，诸如流式细胞术或基于聚合酶链反应的方法等MRD评估技术的应用受到了挑战。本综述总结了液体活检在弥漫性大B细胞淋巴瘤和经典霍奇金淋巴瘤患者的肿瘤负荷评估、治疗反应评估、非侵入性基因组分析及克隆动态监测中的应用。
