Association of circulating tumor DNA from the cerebrospinal fluid with high‐risk CNS involvement in patients with diffuse large B‐cell lymphoma

摘要

Central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) patients correlates with dismal outcomes, and the detection sensitivity of conven- tional diagnosis of lymphoma is restricted. 1–4 Circulating tumor DNA from cerebrospinal fluid (CSF-ctDNA) has played an important part in the application of liquid biopsy for patients with CNS cancers. 5 In this study, we provided new insights into feasibility of CSF-derived biomarkers for CNS relapse diagnosis in DLBCL patients. In clinical setting, the diagnosis of CNS involvement is based on several clinical risk factors including indi- vidual international prognostic index (IPI), number of extranodal involvement (testicular/adrenal/kidney), and serum lactate dehydrogenase (LDH). 6 CNS-IPI, which is a six-risk-factor model developed by a German group (five IPI factors with kidney/adrenal involvement) for CNS diagnosis, has been validated and proved to be useful in clinical settings. 7 Other reported biological risk factors for CNS involvement included MYC gene rearrangements or MYC (MYC proto-oncogene) and BCL2 (B-cell lymphoma 2) dual translocations.