Document Type
Article
Publication Title
Blood Neoplasia
Abstract
Circulating tumor DNA (ctDNA) is a novel biomarker to assess tumor burden, molecular residual disease (MRD), and treatment response in various cancers. To our knowledge, this study reports the largest real-world cohort to date evaluating ctDNA testing, ctDNA-MRD detection, and ctDNA clearance dynamics in newly diagnosed and relapsed/refractory lymphoma. We analyzed plasma from 144 patients with stage I to IV primary lymphoma (aggressive B-cell lymphoma, n = 110; aggressive T-cell lymphoma, n = 13; indolent B-cell lymphoma, n = 15; indolent T-cell lymphoma, n = 6; median, 7 samples per patient). ctDNA was evaluated using a personalized, tumor-informed, multiplex polymerase chain reaction assay (Signatera). Pretreatment ctDNA was detectable in 92% of the evaluable patients. End-of-treatment (EOT) ctDNA-MRD positivity was prognostic of inferior event-free survival (EFS; adjusted hazard ratio [HR], 22.43; 95% confidence interval [CI], 6.76-74.45; P < .0001). In multivariate analysis, EOT ctDNA-MRD positivity was the most powerful independent predictor of EFS (HR, 37.10; 95% CI, 6.20-221.8; P < .001), exceeding the prognostic value of EOT positron emission tomography (PET) positivity (HR, 5.88; 95% CI, 1.35-25.6). Early ctDNA clearance during first-line therapy was associated with significantly improved EFS (adjusted HR, 8.57; 95% CI, 2.55-28.81; P = .005). In the relapsed setting, following CART, ctDNA-MRD negativity predicted prolonged event-free intervals. ctDNA-MRD positivity during posttherapy surveillance was associated with significantly inferior EFS (adjusted HR, 33.74; 95% CI, 9.34-121.82; P < .0001). These data establish ctDNA as a robust biomarker for prognosis, treatment monitoring, and early relapse detection across B- and T-cell lymphoma subtypes, with superior prognostic value over conventional imaging, supporting its integration into response assessment.
First Page
100250
Last Page
100250
DOI
10.1016/j.bneo.2026.100250
Publication Date
5-26-2026
Recommended Citation
Galanina N, Iqbal M, Tomassetti S, Nousome D, Tin A, Gillespie CP, Youngberg H, Miller P, Malhotra M, Widden H, Rodriguez A, Liu MC, Narkhede M, William BM. ctDNA for MRD assessment is prognostic and predictive in newly diagnosed and relapsed/refractory lymphoma. Blood Neoplasia. 2026 May 26;3(3):100250. doi: 10.1016/j.bneo.2026.100250. PMID: 42603998; PMCID: PMC13476554.