Minimal Residual Disease Testing for Diffuse Large B Cell Lymphoma

Clin Lymphoma Myeloma Leuk. 2025 Oct;25(10):e750-e755. doi: 10.1016/j.clml.2025.05.003. Epub 2025 May 7.

Abstract

Purpose of review: 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.

Recent findings: 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.

Summary: 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.

Keywords: CAPP-Seq; Circulating tumor DNA (ctDNA); Next-Generation sequencing (NGS); PhasED-Seq; Polymerase chain reaction (PCR).

Publication types

  • Review

MeSH terms

  • Circulating Tumor DNA* / blood
  • High-Throughput Nucleotide Sequencing / methods
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / blood
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / genetics
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Neoplasm, Residual* / diagnosis
  • Prognosis

Substances

  • Circulating Tumor DNA