The leukaemias are a heterogeneous group of blood cancers, which together, caused
310,000 deaths in 2016. Despite significant research into their biology and therapeutics, leukaemia is
predicted to account for an increased 470,000 deaths in 2040. Many subtypes remain without targeted
therapy, and therefore the mainstay of treatment remains generic cytotoxic drugs with bone marrow
transplant the sole definitive option. In this review, we will focus on cellular mechanisms which
have the potential for therapeutic exploitation to specifically target and treat this devastating disease.
We will bring together the disciplines of autophagy and extracellular vesicles, exploring how the
dysregulation of these mechanisms can lead to changes in the leukaemic microenvironment and the
subsequent propagation of disease. The dual effect of these mechanisms in the disease microenvironment
is not limited to leukaemia; therefore, we briefly explore their role in autoimmunity, inflammation
and degenerative disease.
Keywords: Leukaemia, autophagy, extracellular vesicles, therapeutic, tumour microenvironment, autoimmunity.
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