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Ocular immunology and inflammation

Metagenomic Deep Sequencing Identifies Gene Mutations Associated with Chemotherapeutic Resistance in Vitreoretinal Lymphoma

In 49 patients with vitreoretinal lymphoma (VRL) confirmed by cytopathology, immunohistochemistry, flow cytometry, and/or MYD88 PCR, host-genome metagenomic deep sequencing (MDS) of intraocular specimens cross-referenced against the Catalogue of Somatic Mutations in Cancer identified eight gene mutations associated with chemotherapeutic resistance in six specimens from four patients, including methotrexate-resistance-associated mutations in four specimens from three patients, and in one patient serial sampling at initial vitrectomy and two subsequent recurrences revealed distinct resistance-associated mutations at each time point; that patient died despite multi-agent therapy including rituximab, consolidation regimens, and lenalidomide, whereas the other three patients remained in long-te