DNA nucleosomal fragments have a therapeutic significance in adult acute myeloid leukemia

Aim: Nucleosomal DNA levels in plasma and serum can be correlated with the extent of cell death at a specific time point. The aim of this study was to evaluate the serum level of nucleosomal DNA fragments as an early predictive marker for acute myeloid leukemia (AML) therapy. Materials and methods: This study included 77 participants: 14 healthy volunteers, included in the control group; they ranged in age between 20 and 55 years, median age 36.5 years. Routine investigations such as liver functions, blood urea, serum creatinine, and complete blood count were performed to confirm their healthy state. The patient group included 63 de-novo AML patients. Results: In the patient group, serum nucleosome levels ranged between 25 and 760 AU, with a mean±SD of 203.7±197 and a median of 220. In the control group, serum nucleosome levels ranged between 38 and 99 AU, with a mean±SD of 72.8±20.8 and a median of 80; a statistically significant difference was found between nucleosome levels in patients and its level in the control group (P 0.001). In the patient group, the lactate dehydrogenase (LDH) level ranged between 189 and 2088 U/l, with a mean±SD of 714±413 and a median of 829. In the control group, the LDH level ranged between 100 and 430 U/l, with a mean±SD of 231±125 and a median of 195; a statistically significant difference was found between LDH levels in patients and its level in the control group (P 0.001). Conclusion: It would be valuable to include these markers together with the kinetics of circulating nucleosomal DNA fragments in prospective trials to elucidate their potential additive role in the early prediction of response to therapy. In AML patients, the changes in nucleosomal DNA during the initial phase of induction chemotherapy are valuable markers for the early estimation of therapy response and should be validated in further prospective trials.