Zhongguo shi yan xue ye xue za zhi · 2026
[Clinical Value of Detecting MYD88 L265P Mutation in the Plasma of Patients with Treatment-Naive Diffuse Large B-Cell Lymphoma via Droplet Digital PCR].
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Li Lu-Yang, Yang Yu-Chao, Zhang Min, Wen Xiao-Lian, Tian Zhuan-Zhuan, Li Jing, Su Hong, Zhang Hong-Wei, Yu Bao-Feng, Su Li-Ping, Guan Tao
Аннотация
OBJECTIVE: To detect the MYD88 L265P mutation in cell-free DNA (cfDNA) from the plasma of patients with treatment-naive diffuse large B-cell lymphoma (DLBCL) using droplet digital PCR (ddPCR) technology, and to explore its associations with clinicopathological parameters, treatment response, and prognosis.
METHODS: Plasma samples from 158 patients with treatment-naive DLBCL were collected. cfDNA in the plasma was extracted, and its concentration was measured. The mutation of MYD88 L265P in plasma cfDNA and its variant allele frequency (VAF) was detected by ddPCR. The associations of MYD88 L265P mutation and its VAF value with clinically relevant indicators of DLBCL, as well as their effects on the overall survival (OS) and progression-free survival (PFS) of patients, were analyzed.
RESULTS: The MYD88 L265P mutation was detected in 27 of the 158 treatment-naive DLBCL patients, with a mutation rate of 17.09%. A significantly higher MYD88 L265P mutation positivity rate was observed in patients with the non-GCB subtype (P =0.000 2), Ann Arbor stage III-IV (P =0.001 2), IPI score of 3-5 (P =0.018 2), and elevated lactate dehydrogenase (LDH) levels (P =0.035 2). Among patients with MYD88 L265P mutation, those with Ann Arbor stage III-IV (P =0.023 8), IPI score of 3-5 (P =0.001 8), and elevated LDH level (P =0.000 2) had significantly higher VAF values. However, there was no significant difference in VAF values between patients who achieved remission and those who did not in the mid-treatment response assessment (P >0.05). Patients with MYD88 L265P mutation had a significantly shorter PFS than those without MYD88 L265P mutation (P =0.030 4), while there was no significant difference in OS between the two groups (P >0.05). No significant differences were observed in either OS or PFS between patients with VAF≥10% and those with VAF <10% in the MYD88 L265P positive cohort (P >0.05). After two cycles of treatment, the VAF of MYD88 L265P in patients decreased significantly (P =0.000 2).
CONCLUSION: The MYD88 L265P mutation is associated with poor prognosis in patients with treatment-naive DLBCL, and its VAF can reflect tumor burden. ddPCR technology facilitates the detection of MYD88 L265P mutation, which can be used for serial dynamic monitoring of DLBCL patients to guide efficacy evaluation and predict treatment outcomes.
METHODS: Plasma samples from 158 patients with treatment-naive DLBCL were collected. cfDNA in the plasma was extracted, and its concentration was measured. The mutation of MYD88 L265P in plasma cfDNA and its variant allele frequency (VAF) was detected by ddPCR. The associations of MYD88 L265P mutation and its VAF value with clinically relevant indicators of DLBCL, as well as their effects on the overall survival (OS) and progression-free survival (PFS) of patients, were analyzed.
RESULTS: The MYD88 L265P mutation was detected in 27 of the 158 treatment-naive DLBCL patients, with a mutation rate of 17.09%. A significantly higher MYD88 L265P mutation positivity rate was observed in patients with the non-GCB subtype (P =0.000 2), Ann Arbor stage III-IV (P =0.001 2), IPI score of 3-5 (P =0.018 2), and elevated lactate dehydrogenase (LDH) levels (P =0.035 2). Among patients with MYD88 L265P mutation, those with Ann Arbor stage III-IV (P =0.023 8), IPI score of 3-5 (P =0.001 8), and elevated LDH level (P =0.000 2) had significantly higher VAF values. However, there was no significant difference in VAF values between patients who achieved remission and those who did not in the mid-treatment response assessment (P >0.05). Patients with MYD88 L265P mutation had a significantly shorter PFS than those without MYD88 L265P mutation (P =0.030 4), while there was no significant difference in OS between the two groups (P >0.05). No significant differences were observed in either OS or PFS between patients with VAF≥10% and those with VAF <10% in the MYD88 L265P positive cohort (P >0.05). After two cycles of treatment, the VAF of MYD88 L265P in patients decreased significantly (P =0.000 2).
CONCLUSION: The MYD88 L265P mutation is associated with poor prognosis in patients with treatment-naive DLBCL, and its VAF can reflect tumor burden. ddPCR technology facilitates the detection of MYD88 L265P mutation, which can be used for serial dynamic monitoring of DLBCL patients to guide efficacy evaluation and predict treatment outcomes.