Blood disorders are at the forefront of personalized medicine, achieving record survival rates.

new technologies And innovative medicines cause revolution V That medicine. And yet eternal life is just a chimera, but hematologywho deals with diseases bloodfunctions as an advance in so-called personalized medicine, which achieves record survivors in patients with almost any life expectancy.

The reason is due to the fact that it is easier for doctors and researchers to access and analyze the data. blood cells than other tissues, such as neurons or solid organs, using simple analysis or more complex methods. Thus, over many years of knowledge about blood cells that behave abnormally allowed us to develop medicines based on these changes. And in recent years, great innovations have appeared in the methods of molecular biology and, in particular, in sequencing a huge amount of DNA that has allowed us to learn much more changes and markers in blood diseasesboth malignant and leukemiaas in benign and more common ones, such as thrombosis wave anemia. Based on the sequencing results, individual treatment, which achieve very encouraging results.

For example, the first tumor disease in which genetic abnormality was purchased chronic myeloid leukemia (rare bone marrow cancer) back in 1960, when it was discovered that 90% of patients had abnormalities in chromosomes 9 and 22 (which were called the Philadelphia chromosome). After years, molecular biology revealed that there are two genes on these chromosomes that come together and need to be separated, so drugs were developed aimed at preventing this fusion, which is the first example personalized medicine. This innovation allowed patients who lived on average only four years after being diagnosed with the disease to now have the same life expectancy as healthy people their age. Almost, almost science fiction.

New treatments for chronic myeloid leukemia have allowed patients to live an average of four years longer and have the same life expectancy as healthy people.

“In the field of blood diseases, technological developments in molecular biology and the identification of new markers have allowed us to be tip medicine and that in recent years the prognosis of patients with leukemia and other diseases has changed in this way startling compared to other types of diseases. But obviously this is an approach that starts in one area of ​​medicine and, if it works, is applied to others,” says José Antonio Pérez Simon, head of the hospital’s hematology service. Hospital Virgen del Rocío in Seville.

“In ten years we have little left treatment many people, and there are more of them thanks to knowledge of the biology of hematological tumors,” confirms oncologist Francesc Bosch from Hospital Vall d’Hebron in Barcelona.

“In hematology, the system is so well established and all the hematologists are so integrated into molecular research that all patients (who need it) have access to it.”

Fermin Sanchez-Guijo. Head of the Hematology Department at the University Hospital of Salamanca

In addition, according to Fermin Sánchez-Guillot, professor and head of the department of hematology University Hospital of Salamanca“In hematology, the system is so well established and all hematologists are so integrated into the importance of molecular research that all patients (who needs it) yes access them.” For example, the doctor explains, “in case of special anemia, an in-depth genetic study is carried out or in patients with repeated thromboses to search for additional causes or genetics “to explain why they don’t respond to treatment.” “In general, these techniques are performed for any hematological disease outside the normal range and for all malignant diseases.”

This situation contrasts with access barriers which still exist in other areas such as solid tumors, where mass DNA sequencing is not funded for all types and stages of cancer.

“CAR-T therapy has revolutionized the treatment of certain blood cancers, offering an effective and potentially curative therapeutic alternative for patients with poor prognosis.”

Jose Antonio Perez Simon. Head of the Hematology Department of the Virgen del Rocío Hospital in Seville.

CAR-T therapy

Hematology has also distinguished itself with the revolutionary CAR-T therapy, which involves extracting a patient’s T cells and delivering them through genetic modification, antitumor potential. It is already used in some hematological cancers, such as leukemia and lymphoma, and following its success, it is being studied for use in other diseases and solid cancers. “CAR-T therapy has revolutionized the treatment of certain blood cancers by offering an effective and therapeutic alternative. potentially curative patients with a poor prognosis,” emphasizes Pérez Simon.

However, there are many more unresolved problems, as recently demonstrated by the HematoAvanza conferences organized by the Spanish Society of Hematology and Hemotherapy (SEHH). For example, for blood cancers, the five-year survival rate is 65% for lymphoid tumors and 49% for myelomas, so there is still a long way to go. And with regard to benign diseases, two problems stand out.

Tests

On the one side, anemiawhich is “a silent epidemic that, due to its frequency, is sometimes normalized, although it significantly reduces the quality of life of those who suffer from it”, according to Maria de la O Abio Calvete from University Hospital of Toledo. morbidity Spain has seen an increase in anemia among both children and women as its diagnosis has improved but its causes have not yet been addressed.

AND thrombosis also increases due to aging population, so with 100,000 new cases per year in Spain it is the third cause of death from cardiovascular disease after heart attack and stroke. In addition, 50% of venous thromboses occur after hospitalization But although the health system has recognized the importance of prescribing antithrombotic treatment after Surgical interventionAccording to Ramon Lecumberri from the University Hospital of Navarra, “Only 60% of hospitalized patients who do not undergo surgery receive them because awareness campaigns among health workers have had a poor effect.”

Thus, the goal is to ensure that all hospitalized patients and those who require it receive anticoagulation therapy to avoid venous thrombosis, a leading cause of in-hospital mortality. preventable.