Advances in Exosome Research: Multifaceted Roles in Myeloid Leukemia Progression and Therapy

Recent advancements in exosome research have revealed their crucial role in myeloid leukemia, encompassing chronic myeloid leukemia (CML) and acute myeloid leukemia (AML). Exosomes, small extracellular vesicles released by various cells, play a significant role in intercellular communication and impact key cellular processes such as growth, proliferation, angiogenesis, survival, and apoptosis. In leukemia, exosomes contribute to disease progression and therapeutic resistance by facilitating immune evasion, enhancing tumor cell proliferation, and promoting angiogenesis. For instance, exosomes derived from CML cells can transfer drug resistance to sensitive cells, and some exosomes derived from AML patients contain cytokines like TGF-β1 that inhibit immune cell activity. Exosomes also influence tumor organotropism by interacting with extracellular matrix molecules and modifying the tumor microenvironment. Despite their high potential, clinical applications of exosomes are limited. Their natural nanoparticle properties—such as adaptability, biodegradability, low toxicity, and the ability to cross biological barriers—make them promising candidates for targeted drug delivery and personalized medicine. Further research is necessary to scale up exosome production and harness their full therapeutic potential. By integrating advancements in exosome biology with innovative therapeutic strategies, there is significant potential for improved management and treatment of leukemia.