血液病个体化治疗的新视角

M. Rogalińska
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摘要

在血液病治疗方面取得进展。不幸的是,一些年轻人,由于罕见的不易检测的基因改变,以及大量预处理的老年患者,由于共存的疾病导致患者代谢的变化,对治疗没有反应。此外,有时在遗传或表观遗传水平上熟悉的多样性和改变可能会转移到代谢或细胞信号的多样性上,这可能是患者对治疗没有反应的原因。有趣的是,对于老年患者,对治疗的抵抗也可能作为药物交叉反应的原因发生。为了在给药前对慢性淋巴细胞白血病患者设计有效的抗癌治疗方案,应检查患者白血病细胞对抗癌药物的反应。此外,对于患者对治疗的反应,其他医生以前开过的药物甚至患者的饮食对治疗的成功也很重要。因此,在给患者用药前选择有效的药物,以提高治疗效果,排除治疗耐药是非常重要的。必须指出,对个性化治疗试验的特别关注应集中在以前对治疗有耐药性、对药物更敏感或进行了大量预处理的患者身上。
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New Perspectives in Personalization of Therapy for Hematological Cancers
A progress in treatment of hematological cancers was achieved. Unfortunately, some youngsters, because of rare genetic alterations that are not easy to detect, as well as heavily pretreated old patients, because of coexisting diseases that lead to changes in patient metabolism, do not respond to therapy. Moreover, sometimes familiar diversities and alterations on genetic or epigenetic level that could be transferred on diversities in metabolism or cell signaling might be a reason why patients do not respond to therapy. Interestingly, for older patients a resistance to therapy could also occur as a reason of drug cross-reactivity. For designing of effective anticancer therapy for patient with chronic lymphocytic leukemia before drug administration, patient’s leukemic cell response to anticancer drug(s) should be checked. Moreover, for patient response to treatment, also drugs prescribed previously by other medical doctors or even patients’ diet could be important for achieving therapeutic success of therapy. Therefore it is important to choose the effective drugs before their administration to patient that will improve treatment efficacy and exclude resistance to therapy. It must be stated that the special attention for personalized therapy tests should be focused on patients previously resistant to therapy, more sensitive to drugs or heavily pretreated.
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