Non-Hodgkin lymphomas (NHL) are a heterogeneous group of lymphoproliferative disorders which originates in B-lymphocytes, T-lymphocytes, or natural killer (NK) cells representing 4.2% of all new cancer cases.
Assessed minimal residual disease (MRD) after treatment by NGS of IGH and IGK rearrangements in NHL has been recommended in clinical trials. MRD quantification with this method assesses treatment response in follicular lymphoma (R+CHOP or CVP or B Regimens, Immunotherapy or Imids), in diffuse large B-cell lymphoma (DLBCL: R+CHOP or DHAP or ICE or ESHAP regimens, immunotherapy or stem cell transplant) and mantle lymphoma (RCHOP, RCHAP, RDHA, NORDIC, HYPERCVAD, BR, immunotherapy or stem cell transplant), monitors remission status and detects early relapse.
In addition, cell-free DNA (cfDNA) is a source of tumour DNA useful for the identification of DLBCL mutations, clonal evolution, and genetic mechanisms of resistance. Therefore, cfDNA genotyping of DLBCL is a real-time and non invasive approach to tracking clonal evolution and the emergence of treatment-resistant clones.
The Altum test comprises a DNA-based multigene panel by NGS of bone marrow aspirates at diagnosis, and MRD testing in the follow-up samples with NGS based assays to detect IGH rearrangements with a sensitivity of 1 in 106 nucleated cells and in parallel with a NGS based assay to detect mutated genes identified in the diagnosis panel (Thermofisher platform), and provides a detailed clinical analysis of the results.