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

Rashid Mir^1,*, Jameel Barnawi¹, Naseh A. Algehainy¹, Mohammed M. Jalal¹, Malik A. Altayar¹, Mohammad A. Alanazi¹, Mamdoh Moawadh¹, Faris J. Tayeb¹, Syed Khalid Mustafa², Abdullatif Taha Babakr³, Umair Manghrio⁴, Jaber Alfaifi⁵, Faisal H. Altemani¹
1 Department of Medical Laboratory Technology, Prince Fahad Bin Sultan Chair for Biomedical Research, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
2 Department of Chemistry, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
3 Department of Medical Biochemistry, Faculty of Medicine, Umm al-Qura University, Makkah, Saudi Arabia
4 Laboratory Medicine, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
5 Department of Child Health, College of Medicine, University of Bisha, Bisha, Saudi Arabia
* Corresponding Author: Rashid Mir. Email: email
(This article belongs to the Special Issue: Epigenetic and ncRNA Biomarkers in Cancer: Diagnostic and Prognostic Value)

BIOCELL https://doi.org/10.32604/biocell.2026.076199

Received 16 November 2025; Accepted 02 February 2026; Published online 26 February 2026

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Abstract

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.