Presence of Nucleosomes in Cerebrospinal Fluid of Glioblastoma Patients – Potential for Therapy Monitoring

Abstract

Free nucleic acids are elevated in serum or plasma of patients with various cancers and indicate responsiveness to therapy. Circulating nucleosomes in serum and cerebrospinal fluid (CSF) of 45 patients were studied (10 with glioblastoma, 20 with non-acute neurological disorders, 10 with subarachnoid haemorrhage, and five with non-ruptured aneurysms). Patients with recurrent glioblastoma underwent tumour resection and local chemotherapy. Samples were taken before treatment and daily during the first week after surgery. There were no significant differences between pre-therapeutic nucleosome levels in the various patient groups. In patients with glioblastoma treated by surgery and local chemotherapy, levels of serum and CSF nucleosomes increased moderately during the week after surgery. Postoperatively, three of the 10 patients with glioblastoma developed cerebral oedema when CSF levels increased almost 200-fold reaching a maximum on day 3 after surgery in contrast to patients without oedema. Monitoring CSF levels of nucleosomes in patients with glioblastoma may indicate the development of postoperative complications and warrants further investigations.