Atout Miral, Elwaheidi Hadeel, Maarouf Rand, Albabtain Abdulwahab A, Alhayli Saud, Alshaibani Alfadel, Aljurf Mahmoud, Fakih Riad El
College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
Clin Lymphoma Myeloma Leuk. 2025 May 7. doi: 10.1016/j.clml.2025.05.003.
Diffuse Large B-cell Lymphoma (DLBCL) is challenging to treat in the context of relapsed and refractory disease. Although approximately 65% of patients are cured with frontline chemotherapy, 35% remain refractory or subsequently relapse following frontline therapy, indicating an urgent need for tailored therapies. This review presents how Minimal Residual Disease (MRD) testing, specifically through the analysis of circulating tumor DNA (ctDNA) in blood, serves as a clinical prognostic factor that may predict relapses and aid in treatment decisions.
We describe multiple MRD detection techniques, including droplet digital polymerase chain reaction (DdPCR) and next-generation sequencing (NGS), emphasizing their importance in understanding patients' responses to treatment and in assessing risk levels.
The analysis of ctDNA could be a promising tool to guide physicians to intervene earlier, possibly improving patient outcomes and quality of life. Nonetheless, standardizing these detection techniques and integrating them into clinical practice remain challenging. Future research is crucial to address these barriers, paving the path for greater use of MRD testing in DLBCL management and improving the delivery of effective treatment to patients.
弥漫性大B细胞淋巴瘤(DLBCL)在复发和难治性疾病的背景下治疗具有挑战性。尽管约65%的患者通过一线化疗得以治愈,但仍有35%的患者在一线治疗后仍难治或随后复发,这表明迫切需要量身定制的治疗方法。本综述介绍了微小残留病(MRD)检测,特别是通过分析血液中的循环肿瘤DNA(ctDNA),如何作为一种临床预后因素来预测复发并辅助治疗决策。
我们描述了多种MRD检测技术,包括液滴数字聚合酶链反应(DdPCR)和下一代测序(NGS),强调了它们在了解患者治疗反应和评估风险水平方面的重要性。
ctDNA分析可能是一种有前景的工具,可指导医生更早地进行干预,可能改善患者的治疗结果和生活质量。尽管如此,标准化这些检测技术并将其整合到临床实践中仍然具有挑战性。未来的研究对于克服这些障碍至关重要,为在DLBCL管理中更广泛地使用MRD检测以及改善向患者提供有效治疗铺平道路。