Predicting the Risk of Lymphoma Relapse: Latest Research

After lymphoma treatment, you may wonder if there are factors that increase the risk of lymphoma coming back. Recent studies reviewed how to estimate these risks by studying certain tests. Read a summary of the findings below. 

CtDNA blood testing may predict relapse risk across many lymphoma types

A real-world study looked at ctDNA testing in 148 people with B-cell and T-cell lymphomas. Circulating tumor DNA (ctDNA) are tiny pieces of lymphoma DNA that can be found in the blood. CtDNA was detected before treatment in 95.7% of people. 

The researchers found that ctDNA status at the end of treatment strongly predicted outcomes. People who still had ctDNA at the end of treatment had a much higher risk of an event like relapse or needing a new treatment. 

For patients followed during their first treatment, everyone who did have ctDNA relapsed. That suggests that ctDNA results could become an early warning sign of relapse.

The study also included a small group of people who received CAR T-cell therapy. Those who did not have ctDNA after the infusion were more likely to experience complete remission. People who stayed ctDNA-positive after CAR-T relapsed shortly after. CtDNA may become a helpful tool for more personalized monitoring, but larger studies are still needed before it becomes standard everywhere. 

Read this abstract: Real-world evaluation of ctdna for risk stratification across the spectrum of both aggressive and indolent lymphomas 

A PET/CT tumor volume cutoff may identify a higher relapse risk after CAR-T

Another study focused on people with large B-cell lymphoma treated with CAR-T. A PET/CT scan was used to measure metabolic tumor volume (MTV). MTV estimates how much active lymphoma is in the body. The researchers tested many possible cutoffs and found a key threshold: MTV above 125 mL identified a higher-risk group.

People with high MTV had worse outcomes, such as shorter time without progression and shorter overall survival. They were also less likely to reach a complete response. Importantly, high MTV did not increase rates of side effects like cytokine release syndrome (CRS) or ICANS, which suggests MTV may be more about relapse risk than side effect risk.

The team also introduced a combined outcome called toxicity-free progression-free survival at 12 months. The treatment achieves this outcome only if a person is alive, has no lymphoma progression, and has not experienced severe CRS or ICANS. High MTV was linked to lower odds of meeting the best-case 12-month outcome. For patients, MTV could become one more piece of information used to plan monitoring or clinical trial options.

Read this abstract: Validated PET-CT metabolic tumor volume threshold identifies high-risk relapsed/refractory LBCL and predicts 12-month toxicity-free progression-free survival Post–CAR-T therapy

Conclusion

These studies show that simple blood tests and scans may help doctors better understand who is at higher risk for lymphoma coming back. Tests like ctDNA and measuring metabolic tumor volume with a PET/CT scan may guide how closely someone is monitored after treatment. While more research is still needed, these findings support more personalized care based on each person’s unique risk factors. 

Get the latest lymphoma updates delivered to you! The HealthTree newsletter shares core education, research advances, and more directly to your inbox. 

SIGN UP TODAY