Closer to personalized approach through accepting the gender differences in medicine

Abstract

Results CLL patients demonstrated significant decrease of T-lymphocytes function. Remarkable increase of serum cortisol level was found in CLL patients, whereas no changes in ACTH concentrations were demonstrated. We can guess the existence of serious dysregulation of the hypothalamic-pituitary-adrenal axis. Values of FSH, LH and E in men with CLL were significantly higher than in healthy persons. No significant differences were demonstrated in the levels of abovementioned hormones in female CLL patients. The dysbalance of sex hormones can influence the immune functions. Negative correlation has been demonstrated between E/T radio and T-lymphocyte function in male CLL patients. We can guess that earlier observed worse survival of male CLL patients compared to females can be connected with the impact of sex hormones dysbalance on immune regulation and through that to overall pathogenesis of disease. Males and females normally have dimorphic immune response. It is reasonable to suggest that in pathologic conditions (for example in CLL) immune regulation is altered in different ways in males and females. Sex hormones dysbalance in CLL can be responsible for that. Further studies are needed to clarify whether CLL male and female patients would need different therapy in connection with diversity of pathogenesis and disease progression. In conclusion, there are some arguments presented that gender-based medicine will become irrelevant if all individual factors can be taken into account. However, large databases reveal that gender remains as an independent risk factor. It is important to consider and find out the impact of gender differences in individualised medicine approach.