Circulating tumor DNA may identify patients with diffuse large B-cell lymphoma who are at risk of recurrence, therefore reducing disease burden at relapse, according to a recent study published online ahead of print in The Lancet Oncology.

Researchers led by Mark Roschewski, MD, of the National Cancer Institute and fellow researchers retrospectively analyzed 126 patients who had diffuse large B-cell lymphoma from May 1993 to June 2013, who had no evidence of indolent lymphoma and were previously untreated.

“We aimed to assess whether circulating tumor DNA encoding the clonal immunoglobulin gene sequence could be detected in the serum of patients with diffuse large B-cell lymphoma and used to predict clinical disease recurrence after frontline treatment,” the authors stated.

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At a median follow-up of 11 years, the researchers identified tumor clonotypes in pretreatment specimens from their patients.

Among them, surveillance monitoring of circulating tumor DNA was performed in 107 of those who had achieved complete remission.

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The researchers found that surveillance circulating tumor DNA had a positive predictive value of 88.2 percent and a negative predictive value of 97.8 percent, and was able to identify risk of recurrence at a median of 3.5 months before any evidence of clinical disease.

“Circulating tumor DNA is a promising biomarker to identify patients at high risk of treatment failure,” the authors concluded.


  1. Roschewski, Mark, MD, et al. “Circulating tumour DNA and CT monitoring in patients with untreated diffuse large B-cell lymphoma: a correlative biomarker study.” The Lancet Oncology. DOI: [epub ahead of print]. April 1, 2015.