Highly sensitive surveillance using detection of cell free DNA
Provided herein are methods and computer-readable storage media related to cell-free DNA and uses thereof to determine risk of a condition, such as transplant rejection or cancer, in a subject.
1. A method of treatment of a subject, wherein the subject is a recipient of a transplant, the method comprising:
determining an amount of cell-free DNA not native to the subject in cell-free DNA extracted from a biological sample from the subject obtained within 60 days of receiving the transplant;
determining a risk associated with the transplant in the subject based on the determined amount of the cell-free DNA not native to the subject, which determining comprises comparing the determined amount of the cell-free DNA not native to the subject to a threshold value of cell-free DNA; and
administering an anti-rejection therapy or a therapeutic agent that treats a systemic disease to the subject when the determined amount of the cell-free DNA not native to the subject is greater than the threshold value of cell-free DNA.
2. The method of claim 1 , wherein the risk associated with the transplant is risk of transplant rejection, an anatomical problem with the transplant or injury to the transplant.
3. The method of claim 1 , wherein the threshold value of cell-free DNA is 1%.
4. The method of claim 1 , wherein the method is performed within 30 days of receiving the transplant.
5. The method of claim 4 , wherein the method is performed within 10 days of receiving the transplant.
6. The method of claim 5 , wherein the method is performed within 5 days of receiving the transplant.
7. The method of claim 6 , wherein the method is performed within 3 days of receiving the transplant.
8. The method of claim 1 , wherein the transplant comprises a heart transplant.
9. The method of claim 8 , wherein the subject is a pediatric patient.
10. The method of claim 1 , wherein the therapy is anti-rejection therapy.
11. The method of claim 1 , wherein the biological sample comprises blood, plasma, or serum.
12. The method of claim 1 , wherein the step of administering comprises administering a therapeutic agent that treats a systemic disease.