Innovations and new approaches regarding the detection of measurable residual disease in lymphomas - a systematic review

Abstract

Background: lymphomas are neoplastic diseases arising from cells of the lymphatic tissue and can affect almost any organ in the body. They can arise from B or T cells. B lymphomas are histologically subclassified into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Classical Hodgkin lymphoma (cHL) is the most frequent subtype of HL, composed of Reed-Steinberg cells. Diffuse large B cell lymphoma (DLBCL) is the most common type of NHL, followed by follicular lymphoma (FL) and mantle cell lymphoma (MCL). The treatment options for these lymphomas include chemotherapy, radiotherapy, immunotherapy, or a combination. The existence of lymphoma clonal cells prior to clinical presentation is known as measurable residual disease (MRD). PET/CT is commonly used to evaluate treatment response and identify disease recurrence, but its use during disease surveillance has not led to improved outcomes. Objectives: this article emphasizes the limitations of current MRD monitoring techniques and the need for newer, more sensitive methods. Data sources: systematic search in PUBMED and MEDLINE databases, using the following query: "lymphoma + minimal residual disease + liquid biopsy" Study criteria: cHL, DLBCL, FL, and MCL adult patients whose MRD was assessed using novel liquid biopsy-based methodologies. Results: the use of circulating-tumor DNA, next-generation sequencing, and digital-droplet PCR are considered as potential alternatives for MRD assessment. Limitations: the articles that were included in the analysis are mainly observational studies, and patient characteristic differ between studies, within the same technique. Implications of key findings: these methods have been extensively researched for their potential to detect early disease relapse and open the possibility to start proactive salvage therapy or effectively change treatment strategy.