Nano-engineered precision strategies for hematological malignancies: current advances and translational roadmap

Hematological malignancies (HMs), encompassing acute and chronic leukemia, malignant lymphoma, and multiple myeloma (MM), are among the most lethal cancers globally. Their high mortality is driven by complex genomic alterations, protective effects of the bone marrow (BM) and lymph node microenvironments, and systemic dissemination. Despite advances in chemotherapy, radiotherapy (RT), hematopoietic stem cell transplantation, and targeted or immunotherapies, patients continue to face significant challenges, including drug resistance, treatment-related toxicity, and difficulties in disease monitoring and relapse prevention. To overcome these limitations, research has increasingly focused on nanomaterials. With tunable sizes and programmable surface chemistries, nanocarriers can evade immune surveillance in circulation, preferentially accumulate in BM and lymphoid tissues, and facilitate site-specific drug release within the tumor microenvironment (TME). Moreover, they can integrate multiple therapeutic and diagnostic functionalities, including magnetothermal therapy, photodynamic therapy (PDT), imaging, and immune modulation, positioning them as powerful platforms for integrated diagnosis and treatment. Consequently, nanomedicine is emerging as a critical link between the complex pathology of HMs and the clinical need for precise, individualized interventions. In this review, we first elucidate the biological foundations of therapeutic challenges in HMs and highlight the potential of nanomedicine to address these obstacles. We then categorize and summarize the structural characteristics and biological behaviors of five major classes of nanoplatforms applied to HMs: inorganic, polymeric, hybrid, biogenic, and stimuli-responsive systems. Key advances and representative studies are presented to illustrate how nanomaterials enhance treatment, diagnosis, disease monitoring, and theranostic applications. Finally, we discuss the primary barriers to clinical translation, including scalable GMP-compliant manufacturing, reliable in vivo predictability, and rigorous regulatory assessment, and propose potential solutions such as artificial intelligence (AI)­driven design, modular continuous-flow production, and adaptive clinical trial frameworks. By connecting disease-driven requirements with rational material design and clinical validation, this review provides a comprehensive reference to advance nanotechnology-enabled precision medicine and improve long-term outcomes in HMs.