Macrophages in graft-versus-host disease (GVHD): dual roles as therapeutic tools and targets

Nanotechnology in leukemia therapy: revolutionizing targeted drug delivery and immune modulation

Leukemia, a group of blood cancers, presents a significant global health challenge. Despite advancements in conventional therapies like chemotherapy and immunotherapy, the need for more effective and less toxic treatments remains. Nanotechnology offers a promising avenue for targeted drug delivery and immune modulation in the fight against leukemia. Through the utilization of nanomaterials' special qualities, like their small size, large surface area, and capacity to transport a variety of payloads, scientists are creating novel ways to get around the drawbacks of conventional treatments. These strategies include targeted drug delivery, immune cell activation, and overcoming drug resistance. However, challenges remain in translating these promising nanotechnological approaches into clinical applications. Addressing issues such as toxicity, biodistribution, and regulatory hurdles is crucial for the successful development of nanomedicine for leukemia. In conclusion, nanotechnology offers a promising future for the treatment of leukemia. Continued research and development are essential to unlock the full potential of nanomaterials and improve patient outcomes. The potential of nanotechnology-based strategies to improve the effectiveness of leukemia treatments is explored in this review. We go over the function of different nanomaterials in delivering therapeutic agents to leukemia cells, such as liposomes, polymeric nanoparticles, and inorganic anoparticles. We also investigate the engineering of nanomaterials to influence the immune system and promote anti-tumor reactions.

C-type lectin-like molecule-1 as a diagnostic, prognostic, and therapeutic marker in leukemia

Leukemia, characterized by a heterogeneous spectrum of malignancies arising from the clonal expansion of hematopoietic progenitor cells, continues to represent a significant challenge within the field of oncology. Notwithstanding advancements in diagnostic techniques, therapeutic strategies, and prognostic tools, the complexities surrounding the pathogenesis of leukemia and its diverse clinical manifestations highlight the imperative need for the identification of novel biomarkers aimed at improving patient outcomes. The C-type lectin-like molecule-1 (CLL-1) has recently gained recognition as a particularly promising and appealing therapeutic target within the realm of leukemia. This cell surface receptor is characterized by an exceptionally high expression level on acute myeloid leukemia (AML) blasts. The consistent presence of CLL-1 on these cells not only emphasizes its prospective utility as a therapeutic target but also positions it as an optimal candidate for the surveillance of minimal residual disease (MRD). Furthermore, CLL-1 showcases innovative potential for the formulation of new immunotherapeutic strategies designed to combat leukemia. This narrative review aims to explore the structure, function, and diverse expression patterns of CLL-1 in relation to leukemia, thereby offering critical insights into its pivotal role in the disease's pathogenesis and its potential ramifications for treatment. The investigation of CLL-1 as a feasible target for diagnostic purposes, MRD monitoring, and the creation of novel immunotherapy strategies heralds the commencement of new and promising pathways for therapeutic approaches employed in the management of leukemia. A comprehensive understanding of the complex interplay between CLL-1 and the pathogenesis of leukemia will undeniably contribute to the design and advancement of more targeted and efficacious therapeutic interventions.

Insights into KMT2A rearrangements in acute myeloid leukemia: from molecular characteristics to targeted therapies

Acute myeloid leukemia (AML) with KMT2A rearrangements (KMT2A-r) represents a highly aggressive and prognostically unfavorable subtype of leukemia, often resistant to standard treatments and associated with high relapse rates. KMT2A-r, found in 3-10% of adult AML cases, disrupt epigenetic regulation by forming chimeric proteins that activate oncogenic pathways like HOXA and MEIS1. These fusion proteins recruit cofactors such as Menin and DOT1L, driving leukemogenesis through abnormal histone methylation. Diagnosing KMT2A-r AML requires precision, with traditional methods like FISH and RT-PCR being complemented by advanced technologies such as next-generation sequencing (NGS) and machine learning (ML). ML models, leveraging transcriptomic data, can predict KMT2A-r and identify biomarkers like LAMP5 and SKIDA1, improving risk stratification. Therapeutically, there is a shift from chemotherapy to targeted therapies. Menin inhibitors (e.g., Revumenib, Ziftomenib) disrupt the Menin-KMT2A interaction, suppressing HOXA/MEIS1 and promoting differentiation. DOT1L inhibitors (e.g., Pinometostat) show promise in combination therapies, while novel approaches like WDR5 inhibitors and PROTAC-mediated degradation are expanding treatment options. Despite progress, challenges remain, including optimizing minimal residual disease monitoring, overcoming resistance, and validating biomarkers. This review emphasizes the imperative to translate molecular insights into personalized therapeutic regimens, offering renewed hope for patients afflicted by this historically refractory malignancy.

Mesenchymal stem cell-derived exosomes: a novel therapeutic frontier in hematological disorders

Mesenchymal stem cells (MSCs) are multipotent stromal cells valued for their immunomodulatory and regenerative properties, positioning them as a cornerstone of regenerative medicine. Their derived exosomes small extracellular vesicles laden with bioactive molecules such as proteins, lipids, and nucleic acids have emerged as critical mediators of MSC therapeutic effects. This review systematically explores the biology of MSC-derived exosomes, detailing their biogenesis, molecular composition, and pivotal roles in hematopoiesis, inflammation, and immune regulation. In hematological disorders, including leukemia, lymphoma, and myelodysplastic syndromes, these exosomes exhibit significant therapeutic potential by modulating the tumor microenvironment, enhancing hematopoietic recovery, and suppressing malignant cell proliferation. Notable findings include their ability to induce cell cycle arrest in leukemia cells via the p53 pathway and to reduce chemoresistance through targeted signaling mechanisms, such as the IRF2/INPP4B axis. However, clinical translation is hindered by several challenges, including the standardization of isolation techniques such as ultracentrifugation which are costly and susceptible to contamination as well as difficulties in optimizing large-scale production and ensuring long-term safety and efficacy. Despite these obstacles, MSC-derived exosomes offer a promising, cell-free therapeutic alternative that minimizes risks such as immune rejection and tumorigenicity associated with whole-cell therapies. Future research must prioritize the refinement of isolation and production protocols, the development of precise delivery strategies, and the execution of comprehensive safety evaluations to unlock their full clinical potential in treating hematological disorders and beyond. This review integrates recent advancements to provide a clearer understanding of their multifaceted contributions and highlights the critical gaps that remain.

Platelet-derived extracellular vesicles: emerging players in hemostasis and thrombosis

Platelets, long recognized for their role in hemostasis and thrombosis, have emerged as key players in a wide array of physiological and pathological processes through the release of platelet-derived extracellular vesicles (PEVs). These nanoscale vesicles, rich in bioactive molecules such as proteins, lipids, and nucleic acids, facilitate intercellular communication and influence processes ranging from angiogenesis and inflammation to immune modulation and tissue repair. PEVs, the most abundant extracellular vesicles in circulation, display procoagulant activity 50-100 times greater than activated platelets, underscoring their pivotal role in hemostasis and thrombosis. Recent research has unveiled their dual role in health and disease, highlighting their potential as diagnostic biomarkers and therapeutic vehicles. PEVs are implicated in cancer progression, autoimmune diseases, and infectious diseases, where they modulate tumor microenvironments, immune responses, and inflammatory pathways. Moreover, their ability to deliver therapeutic agents with high specificity and biocompatibility positions them as promising tools in regenerative medicine, drug delivery, and targeted therapies. This review comprehensively explores PEV biogenesis, cargo composition, and their multifaceted roles in hemostasis and thrombosis, as well as their broader implications in disease. It also explores the potential of PEVs as diagnostic markers and innovative therapeutic strategies, offering insights into their application in treating thrombotic disorders, cancer, and inflammatory diseases. Despite significant advancements, challenges remain in standardizing isolation protocols and translating preclinical findings into clinical applications. Unlocking the full potential of PEVs promises to revolutionize diagnostics and therapeutics, paving the way for novel approaches to managing complex diseases.

"Unraveling the Clot-Miscarriage Nexus: Mechanisms, Management, and Future Directions in Thrombosis-Related Recurrent Pregnancy Loss"

Recurrent spontaneous abortion (RSA) is a multifactorial condition influenced by genetic, hormonal, immunological, and anatomical factors. Thrombophilia, characterized by a heightened propensity for blood clotting, is a significant contributor to RSA. This review examines the mechanisms connecting thrombosis and RSA, focusing on hypercoagulable states, placental thrombosis, inflammation, and endothelial dysfunction. Genetic and acquired thrombophilic factors, such as factor V Leiden mutation, prothrombin gene mutation, protein C and S deficiencies, antithrombin III deficiency, antiphospholipid syndrome, and hyperhomocysteinemia, are discussed in detail. The diagnosis of thrombophilia in RSA entails a comprehensive clinical evaluation, including the assessment of physical examination, medical history and laboratory investigations, although there is still debate over the need for universal screening. Therapeutic strategies, including anticoagulant and antiplatelet therapies, as well as lifestyle modifications, are tailored to individual risk factors and disease severity. Although anticoagulant therapy demonstrates potential in lowering the risk of miscarriage, additional research is necessary to refine treatment protocols and assess long-term outcomes. This review highlights the need for a nuanced approach to managing thrombophilia-associated RSA, balancing diagnostic precision with therapeutic efficacy to improve reproductive outcomes.