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Chronotherapy in Hematological Malignancies: Evaluating the Rationale and Evidence
Andrej Belančić1, Marko Skelin1,2, Yun Wah Lam3
1Department of Basic and Clinical Pharmacology and Toxicology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia.
Pharmacology Research & Perspectives
|August 1, 2026
Summary
Timing cancer treatments to the body's internal clock, known as chronotherapy, may improve outcomes for blood cancer patients. This approach considers how circadian rhythms affect treatment effectiveness and side effects, offering a new dimension to precision medicine.
Area of Science:
- Hematological Oncology
- Chronobiology
- Immunology
Background:
- Hematological malignancies are a major cause of death despite advanced treatments.
- Treatment success and toxicity are influenced by the timing of therapy relative to circadian rhythms.
- Circadian clock disruption is linked to cancer development, treatment resistance, and toxicity.
Purpose of the Study:
- To review the role of circadian regulation in blood cancers.
- To explore the preclinical and clinical evidence for chronotherapy in hematological malignancies.
- To discuss challenges and future directions for time-aware cancer treatments.
Main Methods:
- Narrative review of current literature.
- Synthesis of mechanistic, preclinical, and clinical data.
- Examination of practical and technological challenges.
Main Results:
- Circadian rhythms regulate key processes in hematopoiesis and immunity.
- Disrupted circadian clocks can promote cancer and reduce treatment efficacy.
- Limited clinical data suggest treatment timing impacts outcomes in leukemia, lymphoma, and transplantation.
Conclusions:
- Chronotherapy holds promise as a component of precision medicine in hematological oncology.
- Personalized, time-aware therapies can be enabled by emerging technologies.
- Further prospective studies with validated biomarkers and endpoints are needed to define clinical value.
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