Liquid biopsy for disease monitoring after anti‐CD19 chimeric antigen receptor T cell in diffuse large B‐cell lymphoma
Clara Maluquer,
Beatriz Bellosillo,
Alberto Mussetti,
Eva Domingo‐Domènech,
Rocío Parody,
Lierni Fernández‐Ibarrondo,
Roser Velasco,
Gabriel Moreno‐González,
Gabriela Sanz,
Montserrat Cortés,
Anna Sureda
Affiliations
Clara Maluquer
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Beatriz Bellosillo
Pathology Department Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
Alberto Mussetti
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Eva Domingo‐Domènech
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Rocío Parody
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Lierni Fernández‐Ibarrondo
Pathology Department Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
Roser Velasco
Unit of Neuro‐Oncology Department of Neurology University Hospital of Bellvitge Catalan Institute of Oncology IDIBELL, University of Barcelona Barcelona Spain
Gabriel Moreno‐González
Intensive Care Unit Catalan Institute of Oncology University Hospital of Bellvitge IDIBELL, University of Barcelona Barcelona Spain
Gabriela Sanz
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Montserrat Cortés
Radiodiagnostic Unit, IDI (Institut de diagnòstic per la imatge) University of Bellvitge Barcelona Spain
Anna Sureda
Department of Hematology Catalan Institute of Oncology‐Hospitalet, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona Barcelona Spain
Abstract Objectives Chimeric antigen receptor T cells (CARTs) against CD19 antigen represent an effective therapy for relapsed/refractory diffuse large B‐cell lymphoma (rrDLBCL). There is no diagnostic test able to predict which patients with residual disease will relapse from those that will reach a delayed complete response. Positron emission tomography/computed tomography scan (PET‐CT) is characterized by a significant number of false positive results after immunotherapy. Circulating tumor DNA (ctDNA) may be a good‐useful tool to quantify minimal residual disease and for monitoring disease response. Methods We present a patient with DLBCL treated with CART cells in which we tested the combined use of ctDNA and PET‐CT scan. Results Disease reassessment with PET‐CT scan showed a partial remission (3 weeks) and a very good partial remission (2 months). A clinical progression at 3 months was confirmed with PET‐CT scan. Levels of ctDNA progressively decreased and became undetectable. An initial increase in KMT2D p.E4385G variant allele frequency confirmed disease progression. Conclusions Our case shows how the complementary use of ctDNA and PET‐CT scan could be a helpful tool in the clinical management of these patients.
