Lymphoma is a growing health burden in China, with an estimated annual incidence of 6.03 per 100,000 and an increasing trend over the past two decades. At the same time, lymphoma research in China has expanded across molecular diagnostics, targeted therapy, immunotherapy, CAR-T-cell therapy, and transplantation.
A 2026 special issue of the American Journal of Hematology brings together nine studies examining recent advances across several lymphoma subtypes. Beyond new treatments, a recurring theme is the growing use of molecular biomarkers to assess response and identify patients at higher risk.
The Growing Role of ctDNA in Lymphoma
In a prospective multicenter study of peripheral T-cell lymphoma (PTCL), ctDNA showed 75.2% sensitivity for mutations also detected in tumor tissue. Changes in ctDNA concentration and variant allele frequency correlated with treatment response and progression-free survival. Yet, performance varied substantially across subtypes: sensitivity reached 82.1% in angioimmunoblastic T-cell lymphoma but was only 37.1% in extranodal natural killer/T-cell lymphoma.
The findings in primary central nervous system lymphoma (PCNSL) were also notable. In patients receiving rituximab, high-dose methotrexate, and orelabrutinib, clearance of cerebrospinal fluid ctDNA during treatment correlated strongly with complete response and progression-free survival and showed better predictive accuracy than interim PET/CT. Clearance of MYD88 mutations was also associated with favorable outcomes.
These studies show both the potential and the limitations of ctDNA. Its value may depend heavily on the lymphoma subtype and, in diseases such as PCNSL, on sampling the biological compartment where the disease is located.
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New Approaches in T-Cell and NK/T-Cell Lymphomas
Several studies focused on lymphomas where treatment options remain limited. The phase II RCLARITY trial evaluated a chemotherapy-free combination of rituximab, lenalidomide, and chidamide in relapsed/refractory AITL. The regimen produced an overall response rate of 71.4%, with median overall survival of 17.6 months. Clonal immunoglobulin rearrangement was also associated with longer-lasting responses, but this needs to be confirmed in larger studies.
NKTCL received particular attention, reflecting its greater prevalence in East Asia. In a retrospective study of 107 patients with advanced disease who achieved complete remission, upfront autologous stem cell transplantation was associated with higher 3-year PFS than no upfront ASCT, at 78.2% vs 54.6%. The overall survival benefit, however, was not statistically significant after adjustment for other treatment factors.
A prospective study examined stem cell mobilization in patients undergoing transplantation. Among 140 Chinese patients considered poor mobilizers, plerixafor plus G-CSF allowed 80.7% to reach the target of at least 2 × 10^6 CD34+ cells/kg within four or fewer apheresis days, a practical part of the treatment pathway.
Another study looked at what happens after immune checkpoint inhibitor failure, an increasingly relevant question as immunotherapy moves into NKTCL treatment. Among 186 patients, median overall survival after immunotherapy failure was 12.4 months. Immunotherapy retreatment, often combined with other agents, achieved a 44.0% overall response rate and was independently associated with improved survival.
Glofitamab Before CAR-T: Real-World Data
A real-world study looked at whether bispecific antibody treatment affects subsequent CAR-T-cell therapy. Among 64 Chinese patients with relapsed/refractory aggressive B-cell lymphoma, glofitamab-based salvage therapy achieved an overall response rate of 78.7% and a complete response rate of 41.1%. Estimated 1-year progression-free and overall survival rates were 61.3% and 67.7%, respectively.
Prior bispecific antibody exposure did not appear to compromise CAR-T-cell manufacturing or efficacy in this cohort. Responders to glofitamab also had higher baseline CD4+ effector T-cell counts and greater early CD8+ T-cell expansion, suggesting that the functional state of the patient’s T cells may influence response to CD20×CD3 bispecific therapy, pointing to a possible role for glofitamab as a bridge to CAR-T.
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Refining Risk Assessment
Two studies explored risk assessment by combining different sources of biological and clinical information. In PCNSL, whole-genome sequencing and multiplex immunofluorescence were used to define genomic and tumor microenvironment subgroups. Combining the two identified a small high-risk population, 9.8% of the cohort, with a median overall survival of only 3 months. It shows how tumor genomics and the immune microenvironment may provide information that conventional clinical risk factors miss.
A different approach was used in Hodgkin lymphoma among patients aged 60 years or older. A new Geriatric Risk Score combined total lesion glycolysis with age, activities of daily living, hemoglobin, and lymphocyte-depleted histology. In a retrospective cohort of 306 patients, the score separated patients into groups with significantly different outcomes and showed greater discriminatory accuracy than the International Prognostic Score and Comprehensive Geriatric Assessment.
Broader Clinical Relevance
Most of the findings here are not yet practice-changing. Several are early-phase, retrospective, single-center, or exploratory, and the proposed biomarkers, from ctDNA thresholds to the PCNSL genomic classifier to the Geriatric Risk Score, still need prospective validation before they can guide treatment decisions.
What stands out across the issue is the kind of question being asked. Less “which drug works,” more “which patient, measured how, benefits from which sequence.” That framing matters beyond China too, regardless of whether the specific cutoffs generalize.
Access hasn’t kept pace with science. Quality of care and availability of newer therapies still vary widely across the country, and getting advances from major academic centers into routine practice will matter just as much as discovering the next drug.
