Measurable Residual Disease Monitoring in Lymphoma.

Area of Science:

• Hematology
• Oncology
• Molecular Diagnostics

Background:

• Circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) are emerging biomarkers in hematologic cancers.
• Their application in lymphoma for genotyping and disease quantification is expanding.
• Bone marrow disease assessment also plays a role in patient management.

Purpose of the Study:

• To review the evidence supporting the use of ctDNA, CTCs, and bone marrow assessment for monitoring measurable residual disease (MRD) in lymphoma.
• To explore the potential of these biomarkers in aiding clinical decisions, early relapse detection, and prognostication.
• To discuss the application of MRD monitoring across various lymphoma subtypes.

Main Methods:

• Review of numerous clinical trials and studies on MRD monitoring in lymphoma.
• Analysis of data on the prognostic value of MRD for progression-free survival (PFS) and overall survival (OS).
• Examination of MRD-adaptive treatment strategies and comparison with standard surveillance methods.

Main Results:

• MRD monitoring, particularly with serial measurements, is often prognostic for PFS and OS in lymphoma.
• MRD-adaptive strategies are being investigated to personalize treatment by intensifying or de-escalating therapy.
• MRD monitoring demonstrates earlier relapse detection compared to radiographic assessment.

Conclusions:

• MRD monitoring in lymphoma holds significant potential for aiding prognostication, guiding therapy, and enabling earlier relapse detection.
• While not yet routine, MRD monitoring is shaping the future of lymphoma care.
• Standardization and prospective examination of MRD monitoring technologies are underway to advance clinical practice.