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.

Aptamers, which are intricate synthetic molecules composed of single-stranded DNA and RNA, have recently emerged as groundbreaking instruments in the complex and multifaceted realms of diagnosing and treating diverse and challenging cancers, particularly leukemia, a type of blood cancer characterized by the overproduction of abnormal white blood cells. These innovative chemical antibodies, celebrated for their remarkable cost-effectiveness, unparalleled sensitivity, and exceptional precision, provide a promising beacon of hope in the arena of oncology, a field that continuously seeks novel approaches to combat various malignancies. Aptamers are fundamentally transforming the landscape of personalized medicine by adeptly and specifically targeting aberrantly expressed biomarkers, effectively modulating critical signaling pathways, and significantly enhancing the efficacy of drug delivery systems, thereby optimizing therapeutic outcomes for patients. This comprehensive review meticulously highlights the recent advancements in aptamer-based technologies, showcasing their immense potential to refine prognostic models, enhance interventions guided by the presence of minimal residual disease, and broaden the therapeutic options available for patients suffering from high-risk or relapsed forms of leukemia. Nevertheless, in conjunction with their promising applications, this study also delves into an exploration of the myriad of challenges and obstacles that may impede the realization of their full clinical potential in the healthcare setting. Graphic abstract This schematic illustrates the multifaceted roles of aptamers in the context of leukemia. The Design segment outlines the SELEX-based selection and amplification process used to generate aptamer candidates from ssDNA/RNA libraries against target cells or proteins. The Diagnostic section highlights applications of aptamers conjugated with antibodies, nanoparticles, or fluorescent labels for precise detection of leukemia biomarkers. In the Therapeutic domain, aptamers are shown to enable targeted drug delivery, inhibit downstream signaling pathways, and recognize specific leukemia cells. Finally, the Challenges section addresses key translational barriers, including serum stability, renal clearance, safety, and overall performance limitations of aptamer-based systems.

Hematologic malignancies remain among the most difficult cancers to treat, challenged by profound heterogeneity, treatment-induced immune dysfunction, and the frequent emergence of drug resistance. Beyond tumor-intrinsic mechanisms, dysbiosis of the gut microbiome is increasingly recognized as a critical determinant of therapeutic outcomes, shaping hematopoiesis, immune responses, and drug metabolism. Bacteriophage (phage) therapy has re-emerged as a precision tool capable of selectively eradicating pathogenic taxa while preserving commensal short-chain fatty acid-producing communities. Preclinical and early human studies demonstrate that phages can recalibrate microbial ecosystems, disrupt antibiotic-tolerant biofilms, and enrich metabolites such as butyrate that support mucosal integrity and immune balance. Mechanistically, phage DNA enriched with CpG motifs engages Toll-like receptor 9, activating dendritic cells and enhancing cytotoxic T lymphocyte responses, suggesting dual benefits in infection control and anti-tumor immunity. Emerging applications extend further, with engineered phages serving as vectors for CRISPR-Cas gene editing, targeted cytokine delivery, and nanocarrier platforms for leukemia therapy. Despite translational promise, major hurdles persist, including immunogenicity, horizontal gene transfer, resistance evolution, and regulatory uncertainty. Addressing these challenges through GMP-compliant manufacturing, metagenomics-guided personalization, and AI-optimized cocktail design could establish phage therapy as a microbiome-informed adjunct to overcome drug resistance in blood cancers. However, direct clinical evidence of phage therapy efficacy in hematologic malignancies remains limited, and current data are largely derived from preclinical and compassionate-use contexts.