Title |
Noninvasive monitoring of diffuse large B-cell lymphoma by immunoglobulin high-throughput sequencing
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Published in |
Blood, April 2015
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DOI | 10.1182/blood-2015-03-635169 |
Pubmed ID | |
Authors |
David M Kurtz, Michael R Green, Scott V Bratman, Florian Scherer, Chih Long Liu, Christian A Kunder, Kazuhiro Takahashi, Cynthia Glover, Colm Keane, Shingo Kihira, Brendan Visser, Jason Callahan, Katherine A Kong, Malek Faham, Karen S Corbelli, David Miklos, Ranjana H Advani, Ronald Levy, Rodney J Hicks, Mark Hertzberg, Robert S Ohgami, Maher K Gandhi, Maximilian Diehn, Ash A Alizadeh |
Abstract |
Recent studies have shown limited utility of routine surveillance imaging for diffuse large B-cell lymphoma (DLBCL) patients achieving remission. Detection of molecular disease by immunoglobulin high-throughput sequencing (Ig-HTS) from peripheral blood provides an alternate strategy for surveillance. We prospectively evaluated the utility of Ig-HTS within 311 blood and 105 tumor samples from 75 patients with DLBCL, comparing Ig-HTS from the cellular (circulating leukocytes) and acellular (plasma cell-free DNA) compartments of peripheral blood to clinical outcomes and 18FDG PET/CT (n=173). Clonotypic immunoglobulin rearrangements were detected in 83% of patients with adequate tumor samples to enable subsequent monitoring in peripheral blood. Molecular disease measured from plasma, as compared to circulating leukocytes, was more abundant and more correlated with radiographic disease burden. Prior to treatment, molecular disease was detected in the plasma of 82% of patients compared to 71% in circulating cells (p=0.68). However, molecular disease was detected significantly more frequently in the plasma at time of relapse (100% vs. 30%; p = 0.001). Detection of molecular disease in the plasma often preceded PET/CT detection of relapse in patients initially achieving remission. During surveillance time-points prior to relapse, plasma Ig-HTS demonstrated improved specificity (100% vs. 56%, p<0.0001) and similar sensitivity (31% vs. 55%, p=0.4) compared to PET/CT. Given its high specificity, Ig-HTS from plasma has potential clinical utility for surveillance after complete remission. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 10 | 48% |
Spain | 2 | 10% |
Unknown | 9 | 43% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 7 | 33% |
Scientists | 7 | 33% |
Practitioners (doctors, other healthcare professionals) | 5 | 24% |
Science communicators (journalists, bloggers, editors) | 2 | 10% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | <1% |
Israel | 1 | <1% |
United States | 1 | <1% |
Ireland | 1 | <1% |
Unknown | 217 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 34 | 15% |
Student > Ph. D. Student | 28 | 13% |
Student > Master | 27 | 12% |
Other | 23 | 10% |
Student > Bachelor | 16 | 7% |
Other | 42 | 19% |
Unknown | 51 | 23% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 76 | 34% |
Biochemistry, Genetics and Molecular Biology | 32 | 14% |
Agricultural and Biological Sciences | 27 | 12% |
Immunology and Microbiology | 10 | 5% |
Computer Science | 3 | 1% |
Other | 14 | 6% |
Unknown | 59 | 27% |