Personalised treatment of haematological malignancies through systems medicine based on single molecules in single cells.

Abstract

Molecular diagnostics in haematological malignancies continues to advance towards more personalized treatment and accordingly demand is increasing for procedures providing quantitative analyses of heterogeneous tissue in malignancies. Circulating leukaemic cells are diverse and comprise discrete clonal populations arising from a common progenitor cell. Some of the current diagnostic techniques possess an attenuated dynamic quantitative range that prevents a clear comprehension of intercellular interactions. Quantitative measurements will facilitate an accurate appreciation of holistic cellular processes, assist with predictions pertaining to perturbations and reveal functional moieties that are truly a facet of the disease, and thus add to current biomarker discovery which often lack assessment of functional involvement in disease mechanisms and processes. This review focuses on quantitative studies related to peripheral blood and haematological malignancies. Data retrieval for either of these diseases is hampered by the high and unchartered degree of heterogeneity typically existing within clinical samples. The likelihood of analysis across single cell populations is highly probable in the near future. This will allow a patient to be readily screened for malignancies and assigned to a risk group based on a quantitative profile of a complex of molecules related to disease. The future analysis of molecular pathology based on detailed molecular dissection looks promising, requiring the integration of various disciplines encompassing morphology, genetics, expression profiling and new and evolving predictive modeling via systems medicine. From this detailed view into patient health, an increasingly personalized treatment plan can be administered, commencing with stratified medicine.