Evaluation Of Genetic Mutations In Plasma Exosomes As A Biomarker Tool For Detecting The Clonal Evolution Of Leukemic Cells In Pediatric Aml

Introduction: AML is the second most of pediatric leukemia with relapse in >30% of the patients.Clonal evolution of rare primary leukemic cells that survived the initial therapy or gained additional mutations independent of therapy stress, could be the potential cause of relapse in pediatric AML.Therefore, sensitive and reliable methods to measure accurately the mutational shifts between diagnoses, during therapy and relapse could provide useful information on the disease progression.Exosomes are extracellular vesicles of 30-150nm in diameter that are released by both healthy and malignant cells. Exosomes derived from tumor cells or leukemia blasts have emerged as potential valuable biomarkers as they have been illustrated to feature disease specific protein, lipid and nucleic acid signatures that represent the pathological state of the respective cells. While leukemia cells release relatively higher amounts of exosomes compared to healthy cells, mutational profiling of exosomes could be more sensitive than analyzing rare leukemia sub-clone in thehematopoietic compartment.