Title:Prognostic Parameters in Myeloid Malignancies in a Historical Context – From Microscopy to Individualized Medicine
Volume: 22
Issue: 2
Author(s): Paul Jäger*, Sören Twarock and Rainer Haas
Affiliation:
- Department of Hematology, Oncology and Clinical Immunology, University of Düsseldorf, Medical Faculty, Düsseldorf,Germany
Keywords:
Myeloid malignancies, next generation sequencing, diagnostic, targeted therapies, prognosis, artificial intelligence,
allogeneic stem cell transplantation.
Abstract: With this article, we would like to take the reader on a journey into the world of molecular
medicine as it has evolved over the past decades, enabled by advances in genomics. These findings
advanced both the development of prognostic parameters and the evolvement of therapy strategies.
In this manuscript, we will present haematopoietic diseases as a prime example of this
progress because they are relevant not only for their frequency but also for the evident diagnostic
and therapeutic progress. The growing understanding of the underlying pathophysiology originates
from the cellular pathology as it was described by, e.g., Rudolf Virchow (1821-1902). The identification
of specific genomic changes in haematological malignancies and solid tumour diseases provided
us with very sensitive tools for diagnostics and prediction of prognosis. Thus, it paved the
way for individualized or personalized therapy. In particular, the rapid development of sequencing
techniques for the human genome using Next Generation Sequencing (NGS) has contributed to this
progress. Recently, artificial intelligence provided us with the tools to analyze the complex interactions
of genomic alterations, course of the disease, and further factors of as yet unknown significance.
With all these indisputable improvements, we should not neglect the holistic treatment mandate
of personalized therapy, i.e., therapy appropriate to the individual. In this context, the treating
physician should address relevant co-morbidities, the psychosocial embedding of the patient and
his desire for treatment.
