High concentration of plasma cell free DNA alerting disease recurrence in high risk neuroblastoma children

Background Neuroblastoma is the third-most common cancer in children. The high rate of tumor recurrence accounts for a low survival rate in high risk neuroblastoma. Therefore it is clinically of extreme importance to find an effective biomarker for alerting disease recurrence.Methods Total 116 high risk neuroblastoma patients were recruited in Beijing Children’s Hospital from February, 2015 to December, 2017. All patients had received multiple-disciplinary treatment, then went into maintenance treatment phase after evaluation. Blood samples were collected to quantify plasma cell-free DNA (cfDNA) at time points of the beginning of maintenance treatment, every three months afterwards, and diagnosis of recurrence.Results Results showed that 36 high risk neuroblastoma patients developed recurrence during maintenance treatment. The plasma cfDNA concentration was significantly higher in recurrence than in event-free patients (29.34 ng/ml VS 10.32 ng/ml). The time span of cfDNA level higher than 29 ng/ml was consistently detected ahead of recurrence at mean of 0.55 months. The ROC analysis showed that AUC was 0.825, optimal sensitivity and specificity of 80.6% and 71.3% respectively, at cfDNA level of 12.93 ng/ml.Conclusions We concluded that high level of plasma cfDNA could serve as a promising molecular marker to alert recurrence disease in high risk neuroblastoma children.