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Bone marrow transplantation an integral part of precision oncology

NextEdge Admin

12 Oct 2023

4 min 50 sec

Bone marrow transplantation (BMT) also known as hematopoietic stem cell transplantation (HSCT) plays a significant role in precision oncology, which is an approach to cancer treatment that tailors therapies to the genetic and molecular characteristics of each patient’s cancer. Here’s how BMT fits into the framework of precision oncology:

Patient Selection: Precision oncology starts with precise diagnosis and patient selection. Before a BMT, extensive genetic and molecular profiling of the patient’s cancer is often performed to identify specific mutations, markers, and vulnerabilities. This information helps oncologists determine if BMT is a suitable treatment option and which type of transplant (autologous or allogeneic) is most appropriate.
Disease-Specific Considerations: For certain hematologic malignancies like leukemia, lymphoma, and multiple myeloma, BMT is a well-established treatment option. In precision oncology, the choice of BMT may depend on the genetic and molecular characteristics of the cancer, such as specific mutations that indicate a better response to transplant-based therapy.
Targeted Therapies and BMT: Some cancer patients receive targeted therapies before BMT to reduce tumor burden and improve the outcome of the transplant. Precision oncology identifies specific molecular targets that can be inhibited by drugs to make the transplant more effective.
Graft Selection: In allogeneic BMT, selecting a suitable donor is critical. Precision medicine techniques can help match patients and donors more accurately based on genetic compatibility, reducing the risk of graft-versus-host disease (GVHD) and improving transplant success.
Personalized Conditioning Regimen: The conditioning regimen (chemotherapy and/or radiation) used before BMT can be tailored to the patient’s specific disease and health status. Genetic and molecular data can guide the choice of conditioning agents and their dosages.
Monitoring and Relapse Prevention: After BMT, precision oncology plays a role in monitoring the patient’s response and detecting any residual disease or relapse. Molecular and genetic assessments help identify the effectiveness of the transplant and guide post-transplant treatments.
Pharmacogenomics: Precision oncology takes into account the patient’s genetic variations that can affect the metabolism and response to drugs, which is crucial in selecting the right medications and dosages post-transplant to prevent complications and GVHD.
Post-Transplant Care: Ongoing genetic and molecular assessments are used to track the health of the transplanted cells and detect any potential complications. Early detection and intervention can improve patient outcomes.
Long-Term Follow-Up: Patients who undergo BMT require long-term follow-up care, including genetic monitoring, to detect and manage late effects and complications.

Precision oncology, when applied to bone marrow transplantation, helps maximize the success and minimize the complications of the procedure by personalizing every aspect of the transplant process to the individual patient’s genetic and molecular profile. This approach is particularly important in hematologic cancers, where BMT can be a curative treatment option and where the genetic and molecular characteristics of the cancer can significantly impact the choice of therapy and the likelihood of a successful outcome.

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