The prognostic value of clonal heterogeneity and quantitative assessment of plasma circulating clonal IG-VDJ sequences at diagnosis in patients with follicular lymphoma.
Fiche publication
Date publication
janvier 2017
Journal
Oncotarget
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DELMER Alain
Tous les auteurs :
Sarkozy C, Huet S, Carlton VE, Fabiani B, Delmer A, Jardin F, Delfau-Larue MH, Hacini M, Ribrag V, Guidez S, Faham M, Salles G
Lien Pubmed
Résumé
Recent advances in next-generation sequencing (NGS) have enabled the quantitation of circulating tumour DNA (ctDNA) encoding the clonal rearranged V(D)J immunoglobulin locus. We aimed to evaluate the clonal heterogeneity of follicular lymphoma (FL) in the tumour and the plasma at diagnosis and to assess the prognostic value of the ctDNA level. Plasma samples at diagnosis were available for 34 patients registered in the PRIMA trial (NCT00140582). One tumour clonotype or more could be detected for 29 (85%) and 25 (74%) patients, respectively, in the tumour or plasma samples. In 18 patients, several subclones were detected in the tumour (2 to 71 subclones/cases) and/or in the plasma (2 to 20 subclones/cases). In more than half of the cases, the distribution of subclones differed between the tumour and plasma samples, reflecting high clonal heterogeneity and diversity in lymphoma subclone dissemination. In multivariate analysis, a high level of ctDNA was the only independent factor associated with patients' progression-free survival (HR 4, IC 95 (1.1-37), p=.039). In conclusion, an NGS-based immunosequencing method reveals the marked clonal heterogeneity of follicular lymphoma in patients with FL, and quantification of ctDNA at diagnosis represents a potential powerful prognostic biomarker that needs to be investigated in larger cohorts.
Mots clés
circulating tumor DNA, follicular lymphoma, maintenance, prognostic factor, rituximab
Référence
Oncotarget. 2017 Jan 31;8(5):8765-8774