SPECULATION ON PATHOGENESIS OF HEMATOLOGIC MALIGNANCY.

As one review the pathogenesis of Hematologic Malignancy, there is a fundamental difference between a group of Malignancies started by a Gene Mutation driving the disease such has a Myelodysplatic syndrome, and those driven by a Fusion protein (ie Chronic Myelogenous Leukemia or some of the ALK driven lymphoma).  Fusion protein point to the existence of a Core Binding Protein where resulting proteins line up to direct the metabolism of the cell, and in this case a cancer generating Metabolism!  The second group of leukemic process provide many opportunities for treatment.  Blocking the protein to dock onto the CBF is already a significant intervention because it disrupt the trends of the Metabolism.  If you don't believe me, well that's what Gleevec does to cure CML!   I don't want to bore you now with my discussion of CDK and p(number) inhibiting gene, but do you know that with every fusion gene come a particular set of CDK (see CDC2 in CML) and a particular p inhibitor?  we are looking into this !  May be targeting one specific CDK may be all we need in a specific proliferative disease.
Malignancy driver by a gene Mutation still need an anti-histone deacetylator, or an alkylating agents.  But there will be a time when PACHA, DROSHA and DICER will be our focus !  Remember Leukemia are driven by level of expression of regulator genes/enzymes, MiR203 role needs to be further assess!