Biology and Microenvironment
Dino Dujmovic’, Sandra Bašic’ Kinda, Ivo Radman, Goran Lauc, Ivana Ilic’, Igor Aurer
University Hospital Centre Zagreb
Extracellular circulating DNA (cfDNA) can be found in small quantities in plasma of healthy persons, but higher concentrations are found in various disorders including malignant and autoimmune diseases, myocardial infarction, trauma, inflammation and complications of pregnancy. In patients with tumors, cfDNA is of tumor origin. Although it has been studied extensively in solid cancers, there is a dearth of information on cfDNA in hematologic neoplasia. The goal of this study was to determine the concentration of cfDNA in patients with lymphoma, its relation to demographic, biologic and clinical patient and tumor characteristics and to investigate its potential role as a marker of disease activity, prognosis or response to treatment. The study was performed in 29 patients with Hodgkins lymphoma from 2010–2013 lymphoma treated according to standard guidelines (ABVD or eBEACOPP). cfDNA concentration was determined using quantitative real-time PCR before and at the end of treatment.
In HL patients cfDNA concentration is similar with concentrations in healthy persons (median 12.6 ng/ml vs. 12.1 ng/ml), range from 1.95 ng/ml – 546 ng/ml. In our patients cfDNA concentration did not correlated with age, disease stage and both prognostic indexes (early stage and hasenclever). The conctration of cfDNA had no impact on survival (both OS and PFS). In multivariate analysis, cfDNA concentration was not an independent prognostic factor. In the vast majority of patients cfDNA concentrations at the end of treatment were lower than at the beginning but neither the absolute nor relative decline correlated with treatment outcomes.
In patients with Hodgkins lymphoma, cfDNA concentration prior to treatment start does not correlates neither with negative prognostic factors nor with survival. Thus measuring cfDNA does not add independent clinically meaningful information and seems to be neither of diagnostic nor of prognostic value.