Plasma DNA Sequencing Predicts Infections in Leukemia Patients

Microbial DNA testing showed higher predictive sensitivity in acute lymphoblastic leukemia compared to acute myeloid leukemia.

Apr. 3, 2026 at 1:05pm

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A highly detailed, translucent X-ray image showing the complex internal structure of a human blood cell, rendered in shades of blue and purple against a dark background to conceptually represent the medical technology used to detect infections in leukemia patients.An innovative DNA sequencing technique could enable earlier detection of life-threatening bloodstream infections in leukemia patients.Memphis Today

A study found that plasma microbial cell-free DNA metagenomic sequencing (mcfDNA-Seq) could predict bloodstream infections in children and adolescents undergoing leukemia treatment, with notably higher predictive sensitivity in acute lymphoblastic leukemia (ALL) patients compared to acute myeloid leukemia patients. The technique detected pathogens up to 3 days before clinical symptoms appeared, potentially enabling earlier intervention.

Why it matters

Detecting infections early in immunocompromised leukemia patients is critical, as bloodstream infections can quickly become life-threatening. This study suggests mcfDNA-Seq could be a valuable tool to identify infections sooner and guide pre-emptive treatment, potentially improving outcomes for this vulnerable population.

The details

The prospective study at St. Jude Children's Research Hospital analyzed plasma samples from 158 leukemia patients under 25 years old. Overall, mcfDNA-Seq detected the causative pathogen in 51.9% of bloodstream infection episodes in the 3 days before clinical onset, exceeding the 50% sensitivity threshold. Predictive sensitivity was higher in ALL patients (adjusted odds ratio 11.1) compared to acute myeloid leukemia. The technique was less effective at detecting polymicrobial infections.

  • The study was conducted from August 9, 2017 to February 28, 2022.
  • Participants provided plasma samples up to once daily, with a median sampling frequency of 3.4 days per week.

The players

St. Jude Children's Research Hospital

A pediatric treatment and research facility located in Memphis, Tennessee that specializes in childhood cancer and other life-threatening diseases.

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What’s next

The authors suggest that clinical trials are warranted to evaluate using mcfDNA-Seq to guide pre-emptive treatment and prevent infections in high-risk leukemia patients.

The takeaway

This study demonstrates the potential of plasma microbial DNA sequencing to detect infections earlier in immunocompromised leukemia patients, particularly those with acute lymphoblastic leukemia. If validated in further research, this approach could enable faster intervention and improved outcomes for this vulnerable population.