Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Clin Lymphoma Myeloma Leuk. 2021 Apr;21(4):230-237.e12. doi: 10.1016/j.clml.2020.09.007. Epub 2021 Jan 1.
Minimal residual disease (MRD) monitoring has been used to identify early molecular relapse and predict clinical relapse in mantle cell lymphoma (MCL). Few published data exist in MCL on the performance of next-generation sequencing-based assay of immunoglobulin gene rearrangements for MRD assessment.
In a prospective clinical trial (NCT01484093) with intensive induction chemotherapy and autologous stem-cell transplantation, posttreatment peripheral blood samples were collected from 16 MCL patients and analyzed with an earlier version of the Adaptive Biotechnologies MRD assay.
Of the 7 patients whose disease remained in remission, the MRD test remained negative in 5 (71%). Of the 9 patients who experienced relapse, the MRD test was positive at least 3 months before relapse in 6 patients (67%) and positive at the time of relapse in 1 patient (11%). All patients with at least 2 positive MRD tests experienced relapse.
The next-generation sequencing-based MRD assay identified early molecular relapse, and we observed more sensitivity in the cellular (circulating leukocytes) versus acellular (plasma cell-free DNA) compartment. This observation may be due to availability of tumor target or a limitation of the assay.
微小残留病（MRD）监测已被用于识别套细胞淋巴瘤（MCL）的早期分子复发并预测临床复发。关于基于下一代测序的免疫球蛋白基因重排检测用于 MRD 评估的性能，在 MCL 中仅有少数发表的数据。
在一项具有强化诱导化疗和自体干细胞移植的前瞻性临床试验（NCT01484093）中，对 16 例 MCL 患者的治疗后外周血样本进行了分析，采用了 Adaptive Biotechnologies 的早期版本的 MRD 检测。
在 7 例疾病仍处于缓解期的患者中，5 例（71%）MRD 检测为阴性。在 9 例复发的患者中，6 例（67%）在复发前至少 3 个月时 MRD 检测呈阳性，1 例（11%）在复发时呈阳性。所有至少有 2 次阳性 MRD 检测的患者均发生了复发。
基于下一代测序的 MRD 检测可早期识别分子复发，且我们在细胞（循环白细胞）与无细胞（浆细胞游离 DNA）区室中观察到了更高的敏感性。这种观察结果可能是由于肿瘤靶标可用或检测存在局限性。
