Cyclophosphamide is one of the nitrogen mustard agents that is frequently used in cancer chemotherapy. Nevertheless, long-term use of high dosage cyclophosphamide has been proven to increase the risk of secondary cancer. This can be traced by the mutagenic DNA adduct formation, for instance, N5-nitrogen mustard formamidopyrimidine (NM-Fapy-G). Therefore, it may serve as one of the secondary cancer biomarkers in patients receiving cyclophosphamide. Several NM-Fapy-G analysis methods employ Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) developed by experts. However, it was discovered not applicative for patients because cells and tissues were utilized as the biospecimens. Therefore, this summary is presented to emphasize the idea of adopting Dried Blood Spot (DBS) as the blood bio sampling method, DNA extraction and hydrolysis method that is suitable for enriching NM-Fapy-G adduct; and method that is proper for NM-Fapy-G analysis. Based on the literature study, DBS has been proven beneficial for this analysis; DNA can be extracted from the DBS cards using the QIAamp DNA Mini Kit. Therefore, research with a little bit of adjustment can be applied for NM-Fapy-G analysis.
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