Multi-omics advances for molecular characterization, precision medicine, and prognostic implications in leukemia
Shangyu Hou, Junya Liu, Yinghui Zhu
Abstract
Leukemia encompasses a heterogeneous group of hematologic malignancies driven by complex molecular alterations. Recent advancements in genomics, transcriptomics and proteomics have uncovered pivotal molecular markers and oncogenic drivers, shedding light on its complex pathogenesis. Multi-omics integration, incorporating phenotypic and biological behavior profiling offers deeper insights into the molecular landscape and diagnostic approaches in leukemia. In the realm of precision medicine, predicting therapeutic responses remains a critical challenge, with multi-omics strategies aiding in the development of prediction models. Drug resistance in leukemia arises from diverse factors, including genetic and epigenetic mutations, proteomic changes, and microenvironmental factors. The advent of single-cell and spatial omics technologies have further enhanced our understanding of cellular heterogeneity and spatial dynamics contributing to therapy resistance, offering novel therapeutic opportunities. In this review, we will delve into the molecular underpinnings of leukemia through the lens of multi-omics approaches, focusing on their role in deciphering the mechanisms of drug resistance and predicting therapeutic responses. Furthermore, we examine clinical case studies where multi-omics methodologies have been successfully translated into therapeutic decision-making in leukemia.