Extracellular Vesicles in Acute Myeloid Leukemia: Biology, Diagnostic Applications, and Therapeutic Potential

Acute Myeloid Leukemia (AML) is one of the most complex hematological malignancies associated with the rapid production of immature myeloid cells and poor prognosis, even with the development of therapeutic options. Exosomes, which are extracellular vesicles with sizes ranging from 30 to 150 nm, have drawn a lot of interest because of their capacity to carry molecular cargoes, including DNA, mRNA, and non-coding RNAs. Various cells produce these vesicles, which have been shown to effectively transport their molecular contents to target cells via a variety of bodily fluids. This review comprehensively discusses the importance of extracellular vehicles (EVs) in AML development, diagnosis, and therapy. Small extracellular vesicles (sEVs) and exosomes are involved in the intercellular communication in the BM microenvironment and modulate disease development, resistance to therapy, and treatment outcomes. Recent development has shown that they could be regarded as minimally invasive diagnostic markers, especially for the detection of minimal residual disease (MRD) and response to treatment. This review summarises current knowledge on EV biology in AML and discusses their diagnostic and therapeutic potential, along with technical issues and perspectives of the field.