Treatment and the treatment process

Choosing a drug and genetics

The genetics of the leukaemia cell show both the risk and which medicine is likely to work.

Last updated: ~1 min read
DNA and a report — Choosing a drug and genetics
Figure 1.DNA and a report — Choosing a drug and genetics

01Short answer

At diagnosis, chromosomes (cytogenetics) and mutations (molecular tests) are checked in marrow or blood cells. The results help decide treatment intensity, targeted medicines and whether a transplant is needed. These are not inherited genes; the changes arose in the leukaemia cell.

02Simple explanation

Topic. medicine choice and genetics.

Ask. Your team will explain your own situation.

Write down. Your questions.

Overview. The article “Targeted therapy”.

03Scientific explanation

Risk group: genetics helps predict the course of the disease.

Somatic versus inherited: most changes are not inherited; rarely, testing is offered to relatives.

04What happens in the body?

Medicine choice and genetics

At diagnosis, chromosomes (cytogenetics) and mutations (molecular tests) are checked in marrow or blood cells. The results help decide treatment intensity, targeted medicines and whether a transplant is needed. These are not inherited genes; the changes arose in the leukaemia cell.

In more detail

Risk group: genetics helps predict the course of the disease. Somatic versus inherited: most changes are not inherited; rarely, testing is offered to relatives.

A path by gene — Choosing a drug and genetics
Figure 2.A path by gene — Choosing a drug and genetics

The overview

This article goes deep into one subject. For the bigger picture, see “Targeted therapy”.

A lab instrument — Choosing a drug and genetics
Figure 3.A lab instrument — Choosing a drug and genetics

05Medicine choice and genetics: the steps

Four steps.

Sample — Marrow or blood.1SampleMarrow or blood.
Tests — Chromosomes and mutations.2TestsChromosomes and mutations.
Result — Risk and target.3ResultRisk and target.
Plan — Individual choice.4PlanIndividual choice.

06Tests

TestWhat it showsExample
CytogeneticsChromosome changesPhiladelphia chromosome
FISHSpecific breaksBCR::ABL1
Molecular panelMutationsFLT3, NPM1, TP53

07Key terms

Cytogenetics
The study of chromosomes.
Somatic mutation
A change found only in the diseased cell.

08Key points

  • Everyone’s plan is individual.
  • Write down and bring your questions.
  • Report new symptoms early.
  • Do not change medicines yourself.
  • For food, see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”.
  • Overview: “Targeted therapy”.

09Frequently asked questions

Will my children inherit it?

In most cases no; if in doubt, genetic counselling is offered.

Is this the same for everyone?

No; the plan depends on the type of leukaemia and your situation.

Where is the overview?

In the article “Targeted therapy”.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Will my children inherit it?

  2. Is this the same for everyone?

  3. Where is the overview?

My questions

12Sources

  1. National Cancer Institute (NCI). Biomarker Testing / Precision Medicine
  2. National Cancer Institute (NCI). Targeted Therapy to Treat Cancer
  3. MedlinePlus. Leukemia
  4. MedlinePlus. Fluid and Electrolyte Balance
  5. MedlinePlus. Electrolytes
  6. MedlinePlus. Dehydration
  7. MedlinePlus. IV treatment at home
  8. NICE. Having IV fluid therapy (Intravenous fluid therapy in adults in hospital)
  9. National Cancer Institute (NCI). Urinary and Bladder Problems and Cancer Treatment
  10. MedlinePlus. Urinalysis
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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