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Open Access Research article

Early prediction of therapy response in patients with acute myeloid leukemia by nucleosomal DNA fragments

Susanne Mueller1, Stefan Holdenrieder1, Petra Stieber1*, Torsten Haferlach2, Andreas Schalhorn2, Jan Braess2, Dorothea Nagel1 and Dietrich Seidel1

Author Affiliations

1 Institute of Clinical Chemistry, University Hospital Munich-Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany

2 Department of Internal Medicine III, University Hospital Munich-Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany

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BMC Cancer 2006, 6:143  doi:10.1186/1471-2407-6-143

Published: 30 May 2006

Abstract

Background

Elevated levels of nucleosomal DNA fragments can be detected in plasma and sera of patients with malignant diseases.

Methods

We investigated the course of nucleosomal DNA, thymidine kinase, lactate dehydrogenase and leukocytes in sera of 25 patients with acute myeloid leukemia during the first cycle of induction chemotherapy and tested their power to distinguish between patients with complete remission and those with no remission.

Results

Almost all patients showed strongly decreasing levels of nucleosomal DNA during the first week, in some cases after initial peaks. In overall analysis of variance, DNA levels could clearly distinguish between patients with complete remission, who had higher DNA values, and those with insufficient response (p = 0.017). The area under the curve of DNA values of days 2–4 after start of therapy (AUC 2–4) discriminated between both groups with a sensitivity of 56% at a specificity of 100%. Further, pretherapeutic levels and AUC 2–4 of nucleosomal DNA correlated significantly with blast reduction after 16 days. A tendency to higher levels in patients with complete response was also found for thymidine kinase, lactate dehydrogenase and leukocytes, however the difference did not reach the level of significance (p = 0.542, p = 0.260, and p = 0.144, respectively).

Conclusion

Our results indicate that nucleosomal DNA fragments are valuable markers for the early prediction of therapeutic efficacy in patients with acute myeloid leukemia.