Circular DNA is a form of DNA molecules commonly found in nature, like genomic DNA of microorganism, bacterial plasmids, or mitochondrial DNA. As these are DNA molecules that exist independently outside the chromosomes and circular structures, they are called extrachromosomal circular DNA (eccDNA) (1).We have read with great interest the manuscript of Sun et al. (2), in which they proved the gone-wide presence of extrachromosomal circulating DNA and showed its potential in the pathogenesis of esophageal squamous cell carcinoma. EccDNA elements are responsible for carrying DNA sequences that are homologous with demonic DNA (3). Still, they are different from mitochondrial DNA (4), as well as different from circular DNA that is viral covalently closed (5). Various reports investigated the link between eccDNA and cancer biology, as eccDNA is a potential biomarker for cancer monitoring and therapy.Circular DNA is commonly chimeric circularized and amplified, thus greatly impacting the enhanced expression of oncogenes. Still, published data has yet to clarify whether the circularization per se or the subsequent amplification of the copy number may lead to the upregulation of various oncogenes. So far, progress in genetics showed additional roles of eccDNA, other than to promote the amplification and transcription of oncogenes. It may lead to oncogenic remodeling in human malignancies, including leukemia, with important clinical impact (6).As there are still several unanswered questions regarding AML biology, eccDNAs can offer a better understanding of this. Using Chinese cohorts from Shanghai and Beijing, in a collaborative experiment between China and Romania, in the current study we observed 298 upregulated eccDNAs and 71 downregulated eccDNAs in AML patients compared to healthy controls. When considering only eccDNAs from known genes, we observed 273 upregulated eccDNAs and 37 downregulated eccDNAs, most of which were from protein-coding genes (Figure 1). We found a cluster of genes with the P value of 0 (considered by the software) and with a logFC of 1.74. All these eccDNAs were derived from the mitochondrial genome. It must be mentioned that Letter to the Editor