Developing cfDNA-Based Personalized Medicine Approaches for Pediatric Leukemia

Abstract Leukemia with central nervous system (CNS) involvement remains a major clinical challenge, particularly in pediatric populations, where invasive diagnostic procedures like lumbar puncture pose risks and burdens to patients. This project aims to develop and validate a low-cost, non-invasive assay to detect and monitor CNS disease in leukemia patients using cell-free DNA (cfDNA) from peripheral blood. By optimizing V(D)J-targeted PCR for ultra-low input cfDNA and establishing sensitive, quantitative metrics of leukemic burden, we hope to replace or reduce the need for CSF-based diagnostics. This technology could enable real-time treatment monitoring, reduce unnecessary interventions, and improve quality of life, especially in underserved populations.