Acute Lymphoblastic Leukemia in B-Cell Progenitor Patients: Circulating Biomarkers Associated with Diagnosis and Prognosis

Claud Dani^*
*Correspondence: Claud Dani, Department of Plant Physiology and Biophysics, Maria Curie-Skłodowska University, 20-033 Lublin, Poland, Email:

Introduction

Hematological disease known as acute lymphoblastic leukemia is defined by hematopoietic system failure that results in stem cell development being stopped at a particular point, suppressing the normal synthesis of cellular hematologic components. A B-cell lineage progenitor tumor is known as BCP-ALL. There are a number of factors that contribute to the development and maintenance of BCPALL, giving the condition its cytological, genetic, and tumorigenic potential. For the diagnosis and outlook of BCP-ALL, several pathological characteristics are used. The majority of these paraclinical tools, however, can only be acquired through invasive bone marrow aspiration, which can delay illness diagnosis and follow-up in addition to being an anesthetic risk for young patients [1].

Description

Finding accessible and non-invasive methods to provide information on the diagnosis, prognosis, and monitoring of the disease, like circulating biomarkers, is essential because of this. A biomarker in oncology is any quantifiable indicator that shows the presence of malignancy, tumoral behavior, prognosis, or therapy responses. This review covers circulating molecules linked to BCP-ALL that may have diagnostic value, classificatory ability when observing particular clinic aspects of the disease, and/or capacity to identify each BCP-ALL stage regarding its evolution and outcome for BCP-ALL patients. Similarly, we offer and categorize biomarkers that could be useful in future research on clinical strategies or the identification of therapeutic targets for BCP-ALL [2]. A subset of hematological illnesses known as leukemias are characterized by an aberrant cell population that inhibits the normal synthesis of cellular elements of the hematopoietic system. Acute lymphoblastic leukemia, chronic lymphocytic leukemia, Acute Myelogenous Leukemia (AML), and chronic myelogenous leukemia are the four primary subtypes of leukemia that have been recognized based on their time of evolution and hematological lineage. The most prevalent leukemia subtypes in both adults and children are ALL and CLL, respectively.

The World Health Organization describes BCP-ALL as a precursor lymphoid cell neoplasm that is committed to the B cell lineage and is often made up of tiny to medium-sized blast cells with little cytoplasm, moderately condensed to scattered chromatin, and unnoticeable nucleoli. Clinical and analytical tests are used to diagnose BCP-ALL. BCP-ALL symptoms, which can include fatigue or lethargy, constitutional symptoms, dyspnea, dizziness, infections, and easily bruising or bleeding, indicate blast infiltration in the bone marrow, lymphoid system, and extramedullary locations. Laboratory testing to confirm the diagnosis require a BM aspirate, which must show 20% bone marrow lymphoblasts [3].

A biomarker in oncology is any quantifiable indicator that shows the presence of malignancy, tumor behavior, prognosis, or therapy responses. The most promising indicators among the numerous biological components circulating in the bloodstream include circulating tumor cells, cell-free DNA and RNA, proteins and metabolites, and extracellular vesicles. We combined and compiled circulating biomarkers with diagnostic and prognostic potential for BCP-ALL in this review. To find studies published in English up until December 2022, we searched PubMed using the search phrases "plasma biomarker" OR "circulating biomarker" AND "acute lymphoblastic leukemia". Utilizing only certain study types-human, epidemiological, clinical trial, clinical practice recommendations, meta-analysis, observational, and systematic reviews-we narrowed the search [4,5].

Conclusion

Nucleic acid fragments in plasma or serum that are released into the bloodstream as a result of necrosis, apoptosis, autophagy, or mitosis are referred to as circulating cell-free nucleic acids. Patients with malignant disease have altered DNA quantity and integrity indices, and these alterations are connected to the tumour stage. Cf-DNA has been shown to be useful as a biomarker for a variety of malignancies, including early cancer identification, progression, response to treatment, drug resistance, assessing acquired resistance, and therapeutic guidance.

MRD evaluation is frequently applied to the pediatric population. In this context, the term refers to the existence of leukemic cells below the level at which they would normally be detected by morphological techniques. The MRD must be assessed in order to determine the subsequent chemotherapy, immunotherapy, or radiation treatments. Children are put under General Anesthesia (GA) and have BM aspiration for MRD follow-up 2-5 times after their diagnosis; MRD by flow cytometry, one of the most popular procedures to evaluate MRD, requires BMP. General anaesthesia, BMP, together with preparations and related concerns, place quite a strain on children, their families, and hospital staff because, even if little residual leukemia is remaining, it is most reliably and abundantly discovered in the bone marrow.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

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