Exosomes and Their Impact on Chronic Myeloid Leukemia; from Its Progression to the Treatment

Occasionally the disease severity of CML, nay progressat an accelerated rate and the blast phase could be associated with a worse prognosis and a higher mortality rate. Exosomes are nanosized lipid vesicles with the ability to regulate various intra and extracellular mechanisms through transferring their content including proteins, RNAs, miRNAs and DNAs to the tumor microenvironment.

In this study, we aimed to review exosomes structure and biogenesis as well as different exosome sources like CML cells, mesenchymal stromal cells (MSCs), and immune cells. Moreover, the effects of secreted exosomes on CML disease such as their impact on bone marrow niche, drug resistance, leukemic cells growth and CML disease progression is briefly described here.

Since exosomes play extensive roles in the regulation of niche altered by cancer, they can be very valuable in the clinic and in investigating the causes of resistance to treatment. Therefore, one of the therapeutic strategies that can be useful in the recovery process of this group of relapsed patients are exosomes.

In order to prevent disease advancement to accelerated and blast phases, further investigations and clinical trials are required to identify the exact function of exosomes. Therefore, exploring the content of these exosomes and optimizing their application for disease treatment, is needed to prevent disease progression and drug resistance.