Crosstalk of factors underlying bone marrow niche-mediated chemoprotection in acute myeloid leukemia

To outline key cellular and molecular mechanisms underlying AML–niche interactions and their role in chemoresistance.

Review of Mechanisms: Examines how bone marrow niche components contribute to leukemic growth and chemoresistance.
Signaling Pathways: Highlights key signaling pathways essential for leukemic cell homing, survival, and drug resistance.
Emerging Therapies: Discusses therapies targeting the AML niche, including CXCR4 inhibitors and immune-based treatments.

Bone marrow microenvironment plays a critical role in leukemia progression and treatment response.
Leukemic cells remodel the bone marrow niche to promote their own survival.
Key signaling pathways involved include the CXCL12–CXCR4 axis, JAK/STAT, and adhesion-related signaling.
Extracellular vesicles, metabolic changes, hypoxia, and immunosuppression enhance the protective bone marrow environment.