Precision Pharmacy in Hematology: Integration of Pharmacogenomics into Clinical Decision-Making in Anticoagulant and Chemotherapeutic Agents

Riyad Yahya Thubab; Hafed Mohammed Madkhali; Hassan Omar Assiri

doi:10.64483/jmph-81

Authors

Riyad Yahya Thubab Kingdom of Saudi Arabia, Department of Hematology lab, King Fahd Central Hospital, Jazan Cluster, Ministry of Health, Jazan, Saudi Arabia
Hafed Mohammed Madkhali Kingdom of Saudi Arabia, Department of Hematology lab, King Fahd Central Hospital, Jazan Cluster, Ministry of Health, Jazan, Saudi Arabia
Hassan Omar Assiri Kingdom of Saudi Arabia,Department of Hematology lab, King Fahd Central Hospital, Jazan Cluster, Ministry of Health, Jazan, Saudi Arabia

DOI:

https://doi.org/10.64483/jmph-81

Abstract

Background: Precision pharmacy, driven by pharmacogenomics, personalizes anticoagulant and chemotherapeutic therapy based on the genetic profile of the patient, which enhances the outcome of therapy in hematologic diseases. Aim: This review attempts to address the integration of pharmacogenomics into decision-making regarding anticoagulants and chemotherapeutics in hematology with special reference to the pharmacist. Methods: Systematic review of literature using PubMed, Scopus, and Web of Science was conducted for studies between the years 2020-2024. Selection criteria focused on pharmacogenomic applications in hematology. Data were integrated to identify key gene-drug interactions, implementation strategies in clinics, and hindrances. Results: Pharmacogenomic testing of CYP2C9/VKORC1 for warfarin dosing reduced bleeding events by 15%, while TPMT/NUDT15 testing for thiopurines reduced myelosuppression by 25%. Clinical decision support systems (CDSS) and proactive testing, like the PHASER program, improved outcomes by 12–18%. Limitations involve cost, availability, and clinician training constraints. Conclusion: Pharmacogenomics improves the safety and efficacy of anticoagulant and chemotherapeutic treatment in hematology, with pharmacists as central implementers. Continued advances in AI and multi-omics will progressively optimize precision pharmacy.

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