The protective role of the microenvironment in hairy cell leukemia treatment: Facts and perspectives

GARGIULO, ERNESTO; GIORDANO, MIRTA; NIEMANN, CARSTEN U.; MOUSSAY, ETIENNE; PAGGETTI, JÉRÔME; MORANDE, PABLO ELÍAS

Frontiers in Oncology

Frontiers

Lugar: Laussane; Año: 2023 vol. 13

Hairy cell leukemia (HCL) is an incurable, rare lymphoproliferative hematologicalmalignancy of mature B cAlthough first line therapy with purine analogues leads topositive results, almost half of HCL patients relapse after 5-10 years, and standardtreatment may not be an option due to intolerance or refractoriness. Proliferationand survival of HCL cells is regulated by surrounding accessory cells and solublesignals present in the tumor microenvironment, which actively contributes todisease progression. In vitro studies show that different therapeutic approachestested in HCL impact the tumor microenvironment, and that this milieu offers aprotection affecting treatment efficacy. Herein we explore the effects of the tumormicroenvironment to different approved and experimental therapeutic options forHCL. Dissecting the complex interactions between leukemia cells and their milieuwill be essential to develop new targeted therapies for HCL patients.