Circulating tumour DNA (ctDNA) is a promising biomarker for diffuse large B-cell lymphoma (DLBCL) risk stratification and treatment response assessment, but real-world studies were limited. Using a targeted sequencing approach (521-gene panel), we showed that (1) baseline ctDNA level correlated with tumour burden and was an independent predictor of treatment outcome, (2) achievement of minimal residual disease (MRD) negativity was associated with a better treatment outcome and (3) interim MRD-positivity combined with positron emission tomography/computed tomography scan-positivity identified a high-risk subgroup of DLBCL patients. Baseline ctDNA level and treatment related achievement of MRD negativity are valuable prognostic tools in DLBCL to improve risk stratification in routine clinical practice.

1st Department of Medicine Hematology 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

1st Faculty of Medicine BIOCEV Charles University Vestec Czech Republic

1st Faculty of Medicine Institute of Medical Biochemistry and Laboratory Diagnostics Charles University and General University Hospital Prague Prague Czech Republic

1st Faculty of Medicine Institute of Pathological Physiology Charles University Prague Czech Republic

Department of Paediatrics and Inherited Metabolic Disorders 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

The Czech Lymphoma Study Group Prague Czech Republic

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