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ctDNA in cerebrospinal fluid of patients with CNS lymphoma
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Figure 2. Levels of circulating tumor DNA (ctDNA) correlate with disease progression and response to treatment in B- cell lymphomas. (A-F) Longitudinal monitoring of two patients with central nervous system (CNS) lymphomas (NHL2 and NHL4) and (G-L) six patients with systemic lym- phomas with no evidence of CNS disease (NHL8, NHL9, NHL10, NHL13, NHL18, and NHL19) through (A) cere- brospinal fluid (CSF) and (D, G and J) plasma ctDNA analysis (variant allele frequency [VAF] values for each mutation detected using droplet digital polymerase chain reaction [ddPCR]) and its correlation with (B) CSF flow cytometry (cells/μL), (C) cytology (+/- presence/absence of cells), and (F, I and L) radiological imaging (magnetic resonance imag- ing [MRI] and positron emission tomography/computed tomography scans). Data points are vertically aligned (E, H and K). Clinical information for each patient includes type of treatment and radiological response assessment. MRI scans for patient NHL4 are not shown given that the patient only presented leptomeningeal involvement. Dx: time of diagnosis; IT MTX: intrathecal methotrexate; R-CHOP: com- bined therapy (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone); Burk: Burkimab regimen; CR: complete response; EOT: end of treatment; m: month; w: week.
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