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Cell‐free  DNA  (cf DNA ) analysis to detect circulating tumor  DNA  has been focused on monitoring malignant lymphomas. However, clonal hematopoiesis of indeterminate potential ( CHIP )‐associated mutations can also be detected by cf DNA  analysis. Our aim is to investigate the origin of mutations detected in cf DNA  among B‐cell lymphoma patients.   MYD 88 /  CD 79B ,   DNMT 3A , and   TP 53  were chosen as genes of interest, representing each of the following categories: lymphoma driver genes,  CHIP ‐related genes, and genes shared between lymphoma and  CHIP . Seventy‐five B‐cell lymphoma patients were included in this retrospective study. Serum cf DNA s at time of complete metabolic response ( CMR ) were sequenced for   TP 53  (N = 75) and   DNMT 3A  (N = 49).   MYD 88  p.L265P and   CD 79B  p.Y196C/H mutations were analyzed in diffuse large B‐cell lymphoma ( DLBCL ) patients whose tumor samples were available (N = 29). Two and seven mutations in   TP 53  and   DNMT 3A , respectively, were detected in cf DNA  at  CMR . These mutations were detected in either bone marrow mononuclear cells ( BMMC ) or  PBMC . Although four   DNMT 3A  mutations were also detected in tumors, median variant allele frequencies in the tumors (&lt;1.0%) were significantly lower than those in both  BMMC (6.1%)  and serum (5.2%) obtained before the therapy. Conversely, five   MYD 88  and three   CD 79B  mutations detected in tumors were confirmed in cf DNA  before therapy, but not in  BMMC  nor in cf DNA  at  CMR . Thus, all   TP 53  and   DNMT 3A  mutations detected in cf DNA  at remission seemed to originate from  CHIP  rather than from residual disease. Results of liquid biopsy should be carefully interpreted, especially in genes shared between lymphomas and  CHIP .

Mutations found in cell‐free DNA s of patients with malignant lymphoma at remission can derive from clonal hematopoiesis