Drug resistance-related microRNAs in hematological malignancies: Translating basic evidence into therapeutic strategies

Systemic chemotherapy has been used as the first-line therapy for patients with hematological malignancies. Despite the enormous progress in anti-tumor efficacy achieved during the last decades, the development of multidrug resistance (MDR) remains a major challenge in the successful treatment of hematological malignancies. Extensive investigations have discovered diverse mechanisms underlying MDR. More recently, increasing evidence demonstrates that miRNAs play a key regulatory role in MDR in hematological malignancies through modulating drug transporter-related proteins, cell cycle-related proteins, drug targets, autophagy, tumor microenvironment, cell survival signaling and apoptosis pathways. Pre-clinical evidence suggests that miRNAs may prove to be an ideal biomarker for predicting drug response or clinical outcomes, thus holding much promise for the development of targeted therapies and personalized medicines for the treatment of hematological malignancies. This review focuses on molecular mechanisms underlying miRNA-mediated chemoresistance in hematological malignancies and discusses evidence of transitional research aiming to bring drug resistance-associated miRNAs into clinical settings.