PRECISION MEDICINE IN HEMATOLOGY: GENOMIC BIOMARKERS AND THERAPEUTIC INNOVATION IN MYELOID NEOPLASMS

Abstract

Myeloid neoplasms remain one of the most daunting challenges in hematology, marked by profound biological heterogeneity, poor outcomes, and limited therapeutic options. In recent years, however, the integration of genomics has reshaped the field, ushering in the era of precision medicine. Genomic biomarkers such as NPM1, FLT3, IDH1/2, and TP53 now guide prognostic refinement, drive therapeutic decisions, and open avenues for innovative treatments once considered unattainable. This narrative review, grounded in high-impact literature published between 2015 and 2025, highlights how molecular stratification and targeted therapies — including midostaurin, gilteritinib, ivosidenib, venetoclax, magrolimab, and menin inhibitors — are redefining clinical practice. At the same time, it critically addresses persistent challenges, such as cost, unequal access to sequencing, and emerging resistance. Precision medicine in hematology thus emerges not merely as a scientific advance, but as a transformative milestone: the possibility of turning historically dismal prognoses into tangible hope for patients worldwide.