Circulating tumor DNA can be used for risk stratification and relapse prediction as well as response to treatment in diffuse large B-cell lymphoma (DLBCL), according to a new study published in the journal BMC Medicine

Circulating tumor DNA is already a promising tumor-specific biomarker in solid tumors. However, its value in DLBCL has not been thoroughly examined.

In the present study, a team of researchers led by Jun Zhu from the Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma at Peking University Cancer Hospital & Institute in Beijing, China, tested the prognostic and predictive potential of circulating tumor DNA before, during, and after first-line therapy in DLBCL using a lymphoma-specific sequencing panel.

Read more about the prognosis of DLBCL

The researchers analyzed 73 patients with DLBCL and confirmed that circulating tumor DNA levels before treatment could serve as an independent prognostic factor for both progression-free and overall survival.

Moreover, patients who were molecular responders to treatment, ie, presented a greater decrease in the levels of circulating DNA after the first 2 cycles of treatment, had more favorable progression-free and overall survival compared to nonresponders. 

The researchers suggested that interim circulating tumor DNA clearance could be an alternative noninvasive method to predict better progression-free or overall survival. 

Finally, they demonstrated that circulating tumor DNA levels following treatment could be a sensitive indicator of minimal residual disease in patients with a high risk of recurrence even though, based on radiographic findings, they were classed as being in complete remission.

“In conclusion, both pretreatment and dynamic measurements of [circulating tumor DNA] are feasible and can stratify the risk and predict outcomes of DLBCL patients receiving first-line treatment,” the researchers wrote. “Future prospective studies are expected to verify the application of these approaches to patients with DLBCL.”


Li M, Mi L, Wang C, et al. Clinical implications of circulating tumor DNA in predicting the outcome of diffuse large B cell lymphoma patients receiving first-line therapy. BMC Med. Published online October 25, 2022. doi:10.1186/s12916-022-02562-3