Recent Advances in Metal-Based Nanomaterials for the Diagnosis and Treatment of Hematological Malignancies

BACKGROUND: Hematological malignancies, including leukemias, lymphomas and multiple myeloma, remain a major clinical challenge due to the limitations of conventional therapies, such as multidrug resistance, off-target toxicity, and the limited specificity of targeted agents to distinct molecular subtypes. Metal-based nanomaterials (M-NMs) have recently garnered considerable interest as multifunctional platforms capable of overcoming these obstacles, owing to their unique physicochemical properties, including surface plasmon resonance, superparamagnetism, facile surface functionalization and responsiveness to exogenous stimuli. METHODS: This narrative review comprehensively examines recent advances in M-NMs for the diagnosis and treatment of hematological malignancies, with a focus on their transition from inert drug carriers to active theranostic agents. The review first examines the design principles of M-NMs as intelligent delivery systems, highlighting active targeting strategies via antibody-antigen or aptamer recognition, stimuli-responsive controlled release triggered by tumor microenvironmental signals or external physical fields, and synergistic delivery with chemotherapeutics to overcome drug resistance. We then elucidate the direct therapeutic mechanisms based on metal activity, encompassing Fenton chemistry-driven oxidative stress, ferroptosis, magnetic hyperthermia and photothermal conversion, as well as their integration with immunomodulation and multimodal imaging for theranostic applications. RESULTS: Current evidence highlights several biological barriers specific to hematological malignancies, including blood compatibility, circulation kinetics and the protective bone marrow microenvironment, while nanotechnology-based strategies may help address these challenges. Long-term biosafety remains an important consideration for non-biodegradable M-NMs, with emerging approaches focusing on biodegradable or renally clearable architectures. Despite substantial progress, clinical translation remains constrained by target heterogeneity, manufacturing complexity and incomplete understanding of therapeutic sensitivity determinants. CONCLUSIONS: We conclude that future development should prioritize the engineering of biocompatible, degradable nanoplatforms with integrated imaging and immunostimulatory functions, and emphasize that deeper mechanistic insights into metal-cell interactions and microenvironmental modulation will be important for advancing the development and clinical translation of M-NMs in precision hematology.