The curse of dimensionality: a blessing to personalized medicine

We wish to provide an alternative consideration to the recommendations raised in the editorial by Sikic et al1 in Journal of Clinical Oncology relating to the study by Bhojwani et al.2 The study reports gene expression profiles that predict early response and long-term outcome in children with acute lymphoblastic leukemia. Bhojwani et al identified 41 genes out of a 38,500-gene expression data set that were predictive of long-term patient outcome treated on a single protocol and a 24-gene set predictive of early therapeutic response. Of most significance to the field however, was their conclusion that gene expression signatures provide no greater prognostic value compared with current factors such as patient age, WBC count, or karyotyp