Among patients with aggressive B cell non-Hodgkin lymphoma (B-NHL), evaluating circulating microRNAs in cerebrospinal fluid (CSF) samples may be a sensitive approach for detecting secondary central nervous system (CNS) involvement, according to research published in Cancers.

In the setting of B-NHL, CNS involvement is a major risk of mortality to patients, with a 2-year overall survival rate as low as 10%. Patients with NHL face differential risks of CNS involvement, with rates ranging from approximately 5% in mantle cell lymphoma to 25% in Burkitt lymphoma.

Standard contemporary methods for determining CNS involvement in B-NHL include magnetic resonance imaging or computed tomography followed by brain biopsy, flow cytometry, cytology, and CSF biochemistry evaluation. These methods are, however, generally low in both sensitivity and specificity.


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MicroRNAs, non-coding RNAs that negatively regulate gene expression, are often deregulated in the cancer setting, including lymphoma. In this study, researchers attempted to determine any microRNAs linked with CNS involvement in B-NHL.

Overall, samples from 162 patients were included; 108 patients had systemic and 54 had secondary CNS lymphomas. The most common diagnosis was diffuse large B cell lymphoma (97 patients), followed by mantle cell lymphoma (34 patients).

The researchers analyzed CSF and plasma samples at diagnosis, during treatment, and at CNS relapse. Analysis showed that 5 oncogenic microRNAs — miR-19a, miR-20a, miR-21, miR-92a, and miR-155 — linked with secondary CNS lymphoma involvement with high sensitivity.

When the authors combined these microRNAs into an oncomiR index, they noted both high sensitivity and specificity separating CNS lymphomas from systemic disease and malignant controls (area under the curve for diffuse large B cell lymphoma, mantle cell lymphoma, and Burkitt lymphoma: 0.96, 0.93, and 1, respectively).

CSF oncomiR levels were effective for detection of CNS involvement, both in the early stage and at relapse.

“In summary, the study indicates a potential use of microRNA evaluation in CSF and plasma for early detection of secondary CNS involvement in aggressive B-NHL lymphomas, as well as for the monitoring and predicting of therapy efficacy and for the prediction of CNS relapse or its early detection,” the authors wrote.

Disclosure: The study author(s) declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Krsmanovic P, Mocikova H, Chramostova K, et al. Circulating microRNAs in cerebrospinal fluid and plasma: sensitive tool for detection of secondary CNS involvement, monitoring of therapy and prediction of CNS relapse in aggressive B-NHL lymphomas. Cancers (Basel). 2022;14(9):2305. doi:10.3390/cancers14092305