Introduction: Outcomes of majority of patients with advanced TCL are poor. The value of ctDNA as a prognostic marker of chemosensitivity and disease-free survival has been validated in aggressive B-cell lymphomas but its role remain unclear in TCL.
Objective: To determine the feasibility of longitudinal ctDNA monitoring in patients with TCL and relation to clinical outcomes
Methods: We performed a retrospective review of TCL patients treated at our center (2022 -June 2024); plasma samples were analyzed using a tumor-informed ctDNA assay during diagnosis, treatment, and surveillance. Whole exome sequencing was performed on tumor tissue and matched normal blood samples to identify up to 16 patient- and tumor-specific, somatic single nucleotide variants using a clinically validated, tumor-informed mPCR NGS assay (SignateraTM). These variants were monitored in patients' subsequent plasma samples.
Results: 75 plasma samples were analyzed from 10 patients with TCL; lymphoblastic lymphoma (n=2), enteropathy associated T-cell lymphoma (n=2), ALK+ anaplastic large T-cell lymphoma (n=1), PTCL-NOS (n=1), angioimmunoblastic T-cell lymphoma (n=1), hepatosplenic T-cell lymphoma (n=1), and CTCL (n=2). After a median duration of follow-up of 6 (2-24) months, 7 (70%) patients remained alive. In patients with PTCL (n-8), persistence of ctDNA was strongly associated with disease progression and death (relative risk=6; 95% CI=1-35; p=0.04). In 5 patients with PTCL, ctDNA negativity showed 100% concordance with negative PET-CT results.
Conclusions: Our results, albeit with small numbers, suggest that ctDNA is strongly associated with outcomes in patients with PTCL; ctDNA may serve as a useful tool to monitor and prognosticate patients with PTCL when validated in a large cohort of patients.
