The Prognostic and Clinical Utility of Circulating Tumor Dna in Diffuse Large B-Cell Lymphoma: A Systematic Review and Meta-Analysis Publisher



Forghani S ; Shahsavand A ; Samiee R ; Kharaghani M ; Kiumarsi A ; Mahdavi Sabet F ; Akbarzadeh S ; Fattahniya S ; Rostami M ; Rad S ; Mirhosseini AH ; Rostami T ; Janbabai G
Source: npj Precision Oncology Published:2025

Abstract

Circulating tumor DNA (ctDNA) provides a minimally invasive tool for assessing tumor burden and genetic evolution in diffuse large B-cell lymphoma (DLBCL). This systematic review and meta-analysis evaluated 53 studies reporting the association of ctDNA and survival outcomes. High ctDNA concentration at baseline was associated with increased progression risk (hazard ratio (HR): 2.50, 95% confidence interval (CI) 2.15–2.9). The prognostic power of ctDNA intensified during treatment, with end of treatment (EOT) positivity showing the strongest association (HR: 13.69, 8.37–22.39). In patients with a negative EOT positron emission tomography (PET) scan, positive ctDNA was highly specific (90.8%) for subsequent relapse. Critically, in patients with a positive EOT PET scan, a negative ctDNA result decreased the risk of relapse (negative likelihood ratio 0.15, 0.06–0.3). ctDNA concentration reliably reflects tumor burden and treatment response, refining PET findings. Future studies should standardize ctDNA protocols and assess the feasibility of ctDNA-based DLBCL management. © The Author(s) 2025.