Molecular genetic biomarkers in hematological malignancies

Most hematopoietic malignancies are widely disseminated even in their "early" stages and often do not have a well-defined localized phase. This makes them less amenable to conventional early screening methods such as imaging and observation. Furthermore, the staging systems for lymphomas are not particularly useful prognostically, with the possible exception of Hodgkin's disease. However, as currently compared with solid tumors, the extensively detailed understanding of the acquired (somatic) genetic lesions in leukemias and lymphomas provide useful molecular biomarkers for early detection. Moreover, well described high risk groups have been identified. These include individuals who are immunosuppressed, for example, iatrogenically following organ transplantation or those with AIDS. Also at high risk are patients treated with certain chemotherapeutic agents who are at risk for the development of acute non-lymphoblastic leukemia. Accordingly, these clinical settings might prove to be good models for evaluating molecular cancer risk markers and the possible introduction of chemoprevention. Here, we outline the biological basis for the application of biomarkers for the early detection of hematological neoplasia. These concepts may provide the stage for the creation of chemoprevention studies in leukemia and lymphoma.