Diffuse large B-cell lymphoma: Time to focus on circulating blood nucleic acids?

Regazzo, Giulia; Marchesi, Francesco; Spagnuolo, Manuela; Méndez, Ana Belén Díaz; Masi, Sara De; Mengarelli, Andrea; Rizzo, Maria Giulia

doi:10.1016/j.blre.2020.100776

Cited by 9 publications

(7 citation statements)

References 59 publications

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“…For DLBCL speci cally, it is also important to consider how evolving treatment and diagnostic tools will impact disparities in TTD. Disparities based on insurance status and language may be partly related to the extent to which patients can access care: currently, the gold standard method of diagnosis is lymph node biopsy or needle core biopsy, a relatively invasive and expensive procedure [1]. Recent research, however, has investigated the prospect of using cell-free DNA (cfDNA) to both diagnose DLBCL and track clonal evolution of resistant tumor cells, which is comparatively less invasive for patients and more economical [15].…”

Section: Discussionmentioning

confidence: 99%

“…Diffuse large B-cell lymphoma (DLBCL) is the most common high-grade form of non-Hodgkin lymphoma [1]. Prolonged time to diagnosis (TTD) of DLBCL can lead to increased risk of morbidities, with those diagnosed later at risk for more advanced disease at presentation, and tumor related complications including spinal cord compression, which can lead to irreversible de cits, such as paralysis or loss of sphincter control [2].…”

Section: Introductionmentioning

confidence: 99%

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Demographic factors impacting time to diagnosis of diffuse large B-cell lymphoma.

McAlarney

Davitt

Hosgood

et al. 2023

JCO

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e18660 Background: Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin’s lymphoma. Symptoms often include a palpable mass or fever; however, patients can be asymptomatic until the presentation of an oncological emergency, such as end organ complications or tumor lysis syndrome. Delayed diagnosis is related to spinal cord compression and an increased rate of complications from chemotherapy. We investigated factors impacting time until diagnosis. Methods: We performed a retrospective cohort study of DLBCL patients from the Montefiore Health System to determine how demographic factors impacted the time from initial symptom onset until diagnosis. Logistic regression models estimated the associations between race, socioeconomic status, and primary language spoken at home and increased time to diagnosis, stratified by insurance status. Odds ratios for increased time to diagnosis based on language were calculated, based on the number of participants with a time to diagnosis above the median value. Results: In a cohort of 1,076 patients that was 24.7% non-Hispanic White, 26.5% non-Hispanic Black, 7.25% Hispanic, and 41.5% “Other” as per information from Epic, the average time from symptom onset until DLBCL diagnosis was 115.76 days. Average time until diagnosis differed by race: Non-Hispanic White participants had the highest, while Hispanic participants had the lowest (188.4 vs 85.8, p = 0.03). Average age at diagnosis also differed by race: Non-Hispanic Black patients had the lowest age, whereas non-Hispanic White patients had the highest (57.3 vs. 67.4, p < 0.0001). Relative to patients with a preferred language of English, patients who had a preferred language that was Spanish (adjusted OR = 1.99, 95% CI = 0.97-4.06, p = 0.059), or “other” had an increased odds ratio of increased time to diagnosis (adjusted OR = 3.15, 95% CI = 1.01-9.75, p = 0.047). Conclusions: Non-English speaking patients experienced increased time to diagnosis, with non-Spanish speaking patients experiencing an even higher increase in time to diagnosis of DLBCL. Differences by racial or ethnic group supported the finding that primary Spanish speakers experience increased times until diagnosis – Hispanic participants had a lower average time to diagnosis than other racial or ethnic groups, suggesting that the effect of language alone may be greater than this analysis suggested when race and ethnicity is controlled for. Interventions targeted at increasing resources for non-English speaking patients in our diverse patient population, such as increasing the availability of interpretation services, patient literature on preventative screenings in non-English languages, and increasing the number of healthcare workers with competency in common foreign languages, may potentially reduce DLBCL morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demographic factors impacting time to diagnosis of diffuse large B-cell lymphoma.

McAlarney

Davitt

Hosgood

et al. 2023

JCO

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“…As biomarkers, circulating miRNAs play an essential role in the diagnosis, typing, treatment response monitoring, and prognostic prediction of NHL. The detection of miRNA can be performed by reverse transcription PCR, NGS, and microarray techniques ( 25 ). At present, in most NHL studies, miRNA expression has been evaluated in serum.…”

Section: Characteristics and Detection Methods Used In Lbsmentioning

confidence: 99%

Clinical Application of Liquid Biopsy in Non-Hodgkin Lymphoma

Liu

2021

Front. Oncol.

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Non-Hodgkin lymphoma (NHL) is a common type of hematological malignant tumor, composed of multiple subtypes that originate from B lymphocytes, T lymphocytes, and natural killer cells. A diagnosis of NHL depends on the results of a pathology examination, which requires an invasive tissue biopsy. However, due to their invasive nature, tissue biopsies have many limitations in clinical applications, especially in terms of evaluating the therapeutic response and monitoring tumor progression. To overcome these limitations of traditional tissue biopsies, a technique known as “liquid biopsies” (LBs) was proposed. LBs refer to noninvasive examinations that can provide biological tumor data for analysis. Many studies have shown that LBs can be broadly applied to the diagnosis, treatment, prognosis, and monitoring of NHL. This article will briefly review various LB methods that aim to improve NHL management, including the evaluation of cell-free DNA/circulating tumor DNA, microRNA, and tumor-derived exosomes extracted from peripheral blood in NHL.

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“…2,3 To overcome these barriers, liquid biopsies have been introduced and present the benefit of being noninvasive, thereby facilitating serial sampling over the course of the disease. 4 DLBCL, unlike other haematologic malignancies, lacks accessibility to tumour cells in the peripheral blood, thus representing an ideal model in which liquid biopsy may be applied for the identification of clinically useful markers. 3 MicroRNAs (miRNAs), small RNAs frequently deregulated in cancer, circulate in biofluids in a stable form, representing interesting candidates for non-invasive biomarkers.…”

Section: Introductionmentioning

confidence: 99%

“…However, this molecular profiling requires tumour biopsy analyses, invasive procedures that may only capture a static snapshot of DLBCL heterogeneity and are not feasible during follow‐up 2,3 . To overcome these barriers, liquid biopsies have been introduced and present the benefit of being non‐invasive, thereby facilitating serial sampling over the course of the disease 4 . DLBCL, unlike other haematologic malignancies, lacks accessibility to tumour cells in the peripheral blood, thus representing an ideal model in which liquid biopsy may be applied for the identification of clinically useful markers 3 …”

Section: Introductionmentioning

confidence: 99%

MiR‐22, a serum predictor of poor outcome and therapy response in diffuse large B‐cell lymphoma patients

Rinaldi¹,

Marchesi

Palombi

et al. 2021

Br J Haematol

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Diffuse large B-cell lymphoma (DLBCL) is an aggressive, heterogeneous neoplasm where prognostication and therapeutic decision are challenging. The available prognostic tools are not able to identify all patients refractory to treatment. MicroRNAs, small RNAs frequently deregulated in cancer, stably circulate in biofluids, representing interesting candidates for non-invasive biomarkers. Here we validated serum miR-22, an evolutionarily conserved microRNA, as a prognostic/predictive biomarker in DLBCL. Moreover, we found that its expression and release from DLBCL cells are related to therapy response and adversely affect cell proliferation. These results suggest that miR-22 is a promising complementary or even independent non-invasive biomarker for DLBCL management.

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Diffuse large B-cell lymphoma: Time to focus on circulating blood nucleic acids?

Cited by 9 publications

References 59 publications

Demographic factors impacting time to diagnosis of diffuse large B-cell lymphoma.

Demographic factors impacting time to diagnosis of diffuse large B-cell lymphoma.

Clinical Application of Liquid Biopsy in Non-Hodgkin Lymphoma

MiR‐22, a serum predictor of poor outcome and therapy response in diffuse large B‐cell lymphoma patients

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