5-Hydroxymethylcytosine profiles of cfDNA are highly predictive of R-CHOP treatment response in diffuse large B cell lymphoma patients

Clin Epigenetics. 2021 Feb 11;13(1):33. doi: 10.1186/s13148-020-00973-8.

Abstract

Background: Although R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) remains the standard chemotherapy regimen for diffuse large B cell lymphoma (DLBCL) patients, not all patients are responsive to the scheme, and there is no effective method to predict treatment response.

Methods: We utilized 5hmC-Seal to generate genome-wide 5hmC profiles in plasma cell-free DNA (cfDNA) from 86 DLBCL patients before they received R-CHOP chemotherapy. To investigate the correlation between 5hmC modifications and curative effectiveness, we separated patients into training (n = 56) and validation (n = 30) cohorts and developed a 5hmC-based logistic regression model from the training cohort to predict the treatment response in the validation cohort.

Results: In this study, we identified thirteen 5hmC markers associated with treatment response. The prediction performance of the logistic regression model, achieving 0.82 sensitivity and 0.75 specificity (AUC = 0.78), was superior to existing clinical indicators, such as LDH and stage.

Conclusions: Our findings suggest that the 5hmC modifications in cfDNA at the time before R-CHOP treatment are associated with treatment response and that 5hmC-Seal may potentially serve as a clinical-applicable, minimally invasive approach to predict R-CHOP treatment response for DLBCL patients.

Keywords: 5-Hydroxymethylcytosine (5hmC); Diffuse large B cell lymphoma; Epigenetics; Logistic regression modeling; R-CHOP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 5-Methylcytosine / analogs & derivatives*
  • 5-Methylcytosine / blood
  • 5-Methylcytosine / metabolism
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / metabolism*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Pharmacological / metabolism
  • Cell-Free Nucleic Acids / metabolism*
  • Cohort Studies
  • Cyclophosphamide / metabolism
  • Cyclophosphamide / therapeutic use
  • DNA Demethylation / drug effects
  • Doxorubicin / metabolism
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Logistic Models
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / metabolism
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prednisone / metabolism
  • Prednisone / therapeutic use
  • Rituximab / metabolism
  • Rituximab / therapeutic use
  • Sensitivity and Specificity
  • Vincristine / metabolism
  • Vincristine / therapeutic use

Substances

  • Biomarkers, Pharmacological
  • Cell-Free Nucleic Acids
  • R-CHOP protocol
  • 5-hydroxymethylcytosine
  • Rituximab
  • Vincristine
  • 5-Methylcytosine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone