Leukemia is a rare disease, but it has an acute impact on the health and life expectancy of patients. In recent years, great progress has been made in the diagnosis and treatment of these patients and leukemias (along with other blood cancers), which have arrived at the heart of an innovative model of medicine and healthcare organization, known as personalized medicine.
Personalized medicine aims to clarify the genetic basis of diseases and to use this knowledge to improve the diagnostic/prognostic definition of patients. In this way, the development of innovative treatments will be based on the individual genomic profile.
“Hematological neoplasms are the ideal context for the implementation of personalized medical programmes,” explains Professor Matteo Della Porta, Head of the Leukemia Section in Humanitas. These diseases have a critical impact on human health and health planning. Moreover, their impact is steadily increasing due to the progressive ageing of the population. It is estimated that the development of a health model based on personalized medicine can lead to an increase in the quality of life and life expectancy of the population.
The new classification of hematological diseases
The new classification of hematological diseases of the World Health Organization (WHO), published in 2016, fully accepts the need to develop the system towards a model of personalized medicine, defining most diseases on the basis of molecular-biological criteria.
In order to take on board the diagnostic criteria of the new WHO classification, it is necessary to implement operational paths that integrate multidisciplinary clinical and biological competencies.
The new WHO classification has also been recognized as a priority in education by the European School of Hematology (ESH). We organized a conference in Dublin, concluded on 11 March, entitled: WHO Classification: Towards Personalized Medicine in Hematology. We discussed the clinical and therapeutic implications of the new classification system in the presence of hematologists from all over Europe.
Humanitas is the first hospital to have formalized, in September 2016, a multidisciplinary diagnostic path in hematology. We have created a working team with all the professionals involved: hematologist, morphologist, interfluorimetricist, pathologist and molecular biologist. The multidisciplinary diagnostic team will make it possible to increase the quality of diagnoses and facilitate an efficient adaptation of innovation processes, also thanks to the study of genomic alterations specific to the individual patient “.
Accelerating the time between research and benefit to patients
The implementation of personalized medicine presents two critical points: the need to integrate high-level scientific, medical and technological expertise, and a strong push to accelerate technology transfer. In other words, the challenge in the field of leukemia today is to be able to quickly integrate the discoveries made in the course of laboratory research with the patient’s clinical path.
In some countries (such as the United States) specific programmes have been funded to bridge the technological gap necessary for the implementation of a personalized medical programme for critical diseases. In Italy, where no personalized medicine system-project has been planned, there is a clear need to favor the emergence of technological districts aimed at integrating research, training and innovation in this specific area.
The Lombardy Hematological Network
Humanitas is part of the Lombardy Hematology Network (LHN), which since 2008 has brought together centers of excellence for the treatment of leukemia. LHN recently launched a personalized blood cancer medicine programme, funded by the Regional Biomedical Research Foundation.
The objective of the Humanitas in leukemia programmes is to clarify the genetic basis of diseases and to ensure that hematological patients have access to the best treatment through the development of innovative treatments based on individual genomic profiles. This project will allow the choice of the best treatment at individual level, with appropriateness and rationalization of resources in the use of medicines, thanks to the advancement of knowledge of diseases in individual patients. It will also attract innovative clinical trials, ensuring that patients have access to the best care.
In Humanitas we already have research laboratories and clinical practice with high level professionalism: these are the necessary elements to make the project a winning one. We are also one of the few hospitals in Italy accredited according to the new AIFA regulations for the testing of drugs from the earliest stages of use on human subjects “.
The importance of the international context
Humanitas, a reference center for the treatment of leukemia, has played a fundamental role in the birth of EuroBloodNet, a European reference network for rare hematological diseases (leukemia), an innovative platform at European level.
The EuroBloodNet project includes blood centers of excellence in more than ten European countries, including Humanitas Cancer Center and aims to:
- Improve equality in the provision of health care for rare hematological diseases in Europe, through the creation and coordination of centers of excellence and the collection of patient data within disease registries.
- Promote the dissemination and implementation of specific guidelines for each disease and their ongoing updating.
- Promote the development of innovative clinical trials and the creation of platforms and new technologies, support research and the identification of new pharmacological targets.
EuroBloodNet will become a key structure to improve the services for the clinical management of patients with leukemia, providing them with the best possible care.