Advances in the assessment of minimal residual disease in mantle cell lymphoma
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(2020) 13:127
REVIEW
Open Access
Advances in the assessment of minimal residual disease in mantle cell lymphoma Dayoung Jung1, Preetesh Jain1,2, Yixin Yao1 and Michael Wang1*
Abstract The clinical impact of minimal residual disease detection at early time points or during follow-ups has been shown to accurately predict relapses among patients with lymphomas, mainly in follicular and diffuse large B cell lymphoma. The field of minimal residual disease testing in mantle cell lymphoma is still evolving but has great impact in determining the prognosis. Flow cytometry and polymerase chain reaction-based testing are most commonly used methods in practice; however, these methods are not sensitive enough to detect the dynamic changes that underline lymphoma progression. Newer methods using next-generation sequencing, such as ClonoSeq, are being incorporated in clinical trials. Other techniques under evolution include CAPP-seq and anchored multiplex polymerase chain reaction-based methods. This review article aims to provide a comprehensive update on the status of minimal residual disease detection and its prognostic effect in mantle cell patients. The role of circulating tumor DNA-based minimal residual disease detection in lymphomas is also discussed. Keywords: Minimal residual disease, Mantle cell lymphoma, ctDNA, Liquid biopsy, Next-generation sequencing
Background Minimum residual disease (MRD) in lymphoma refers to the presence of a minimal burden of clonal lymphoma cells without apparent signs or symptoms of the disease [1]. Residual cancer can persist in either the bloodstream as circulating tumor cells or can be tracked in tissue sites as circulating tumor DNA, making MRD detection possible via peripheral blood (PB) or bone marrow (BM) samples [2, 3]. These persistent cancer cells can predict relapse or recurrence of tumors in almost all cancer types, making MRD status a good prognostic marker (Fig. 1). MRD detection methods have been widely studied in patients diagnosed with chronic lymphocytic leukemia (CLL) and now in large B cell lymphomas. These studies identified MRD to be a strong independent prognostic marker predicting disease recurrence [1, 4–6]. Thus, it is important for these methods to be * Correspondence: [email protected] 1 Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA Full list of author information is available at the end of the article
highly sensitive to detect lowest levels of clonal cells and provide clinicians with a valuable prognostic method, possibly aiding in better clinical management. As such, the detection of residual disease has proven beneficial for patient management. MRD detection is especially important in non-Hodgkin’s lymphomas (NHLs) as a prognostic factor, including diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), and mantle cell lymphoma (MCL) [7]. Although MCL only represents about 6% of all NHL cases, it is one of the most aggressive subtypes with a median overall survi
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