Unveiling the roles of extracellular vesicles in hematologic malignancies: Pathogenesis, diagnostic tools, and clinical translation

Abstract Hematologic malignancies (HMs) are aggressive neoplasms originating from lymphoid or myeloid lineages. They are characterized by heterogeneous clinical manifestations, high refractoriness, and frequent relapse. Recent advances in extracellular vesicle (EV) research have revealed their translational potential in improving the diagnosis, prognosis, and treatment of HMs. EVs are nanoscale membrane‐bound particles secreted by cells. They carry bioactive cargo, including nucleic acids, proteins, and metabolites, and mediate intercellular communication. In HMs, EVs play essential roles in tumor initiation, progression, metastasis, angiogenesis, metabolic reprogramming, and drug resistance, positioning them as pivotal contributors to disease pathogenesis. Leveraging their functional versatility and disease‐specific molecular signatures, EVs show promise as non‐invasive biomarkers for early detection and disease monitoring. They also represent potential therapeutic targets to disrupt tumor‐microenvironment crosstalk, and as engineered drug delivery systems for precision medicine. This review systematically examines the pathobiological functions of EVs in HMs and highlights emerging clinical applications, offering valuable insights to guide future research.