Extracellular Vesicles in Acute Myeloid Leukemia: Opportunities and Obstacles for Therapeutic Advancement

Acute myeloid leukemia (AML) is a disease characterized by uncontrolled proliferation and blocked maturation of hematopoietic stem and progenitor cells. Despite progress in its clinical management, many patients continue to relapse or show limited response to standard therapies, emphasizing the need for novel, safe, and more effective targeted treatment approaches. In recent years, research has increasingly focused on uncovering the mechanisms responsible for treatment failure to optimize therapeutic strategies. Particular attention has been directed toward the role of extracellular vesicles (EVs) released by AML cells and the ways in which the tumor microenvironment (TME) adapts to promote leukemia progression and survival. Concurrently, advances in biotechnology have led to growing interest in using EVs as therapeutic tools in hematologic malignancies. EVs can function as carriers that induce apoptosis in cancer cells or suppress oncogene expression through their RNA cargo. Therefore, this review aims to synthesize and discuss recent discoveries on the roles and therapeutic potential of EVs in AML.