Extracellular vesicles in hematological malignancies

Extracellular vesicles (EVs) act as transporters that carry regulatory molecules between cells in physiologic and pathologic states; therefore, they play a crucial role in thrombosis, inflammation, angiogenesis, vascular dysfunction and other processes that affect the course of hematologic diseases. Within the tumor microenvironment, for example the leukemic bone marrow, EVs-mediated signaling may direct the activities of surrounding cells and act as a positive feedback loop that contributes to cancer progression. The importance of EVs in hematological malignancies is also attributed to their involvement in development of multidrug resistance and the hypercoagulable state related to hematologic disorders, which may be partially influenced by an increase in the total number of EVs. In this review, we focused on the role of EVs in hematologic malignancies and in particular on their influence on the BM microenvironment, their role in angiogenesis and the possible use of EVs as biomarkers of disease progression and drug resistance.