Markers of Therapy Resistance in Hematologic Disorders

Therapy resistance, minimal residual disease, disease persistence, and relapse remain central challenges across hematologic malignancies and related hematologic disorders. Increasing evidence indicates that resistance does not arise solely from tumor-intrinsic evolution but is shaped by dynamic interactions with the bone marrow and tissue microenvironments, including stromal, vascular, and immune components. These interactions influence survival signaling, cell state transitions, metabolic adaptation, and immune evasion, ultimately affecting treatment response.A wide range of resistance markers has been proposed, spanning genomic and epigenomic alterations, transcriptional and proteomic programs, metabolic and redox signatures, microenvironment-derived signals, and circulating factors. Among these, extracellular vesicles (EVs) have attracted growing attention as both functional mediators and measurable biomarkers. EVs can carry microRNAs, proteins, metabolites, and lipids that reflect therapy-induced stress responses and microenvironmental remodeling, while also participating in bidirectional communication between malignant cells and their niches.This Research Topic aims to provide an integrated view of markers of therapy resistance in hematologic disorders, highlighting emerging mechanistic insights, biomarker discovery and validation strategies, and translational opportunities. We welcome contributions addressing how resistance markers arise, how they can be measured longitudinally (including liquid biopsy approaches), and how they may be used to improve patient stratification, predict response, monitor disease, and guide therapeutic interventions. By bringing together cellular, molecular, and clinical perspectives, this Topic will support the identification of robust, actionable resistance markers and accelerate their path toward clinical implementation.Manuscripts may address, but are not limited to, the following themes:• Molecular and cellular markers associated with therapy resistance, persistence, minimal residual disease, and relapse across hematologic disorders• Microenvironmental and niche-derived markers (stromal, endothelial, immune) linked to treatment response• Metabolic and redox-associated signatures of resistance (oxidative stress pathways, mitochondrial programs, nutrient utilization)• Extracellular vesicles as functional mediators and biomarkers of therapy resistance (cargo, release, uptake, and clinical correlates)• Circulating biomarkers and liquid biopsy approaches (extracellular vesicles, cell-free nucleic acids, proteins, metabolites) for response prediction and monitoring• Resistance markers in the context of chemotherapy, targeted therapies, and immunotherapies (including mechanisms of adaptive resistance)• Translational studies focused on biomarker validation, patient stratification, predictive models, and therapeutic strategies informed by resistance markersWe welcome original research, systematic reviews, and perspectives covering biomarker discovery and validation, preclinical models, translational pipelines, and clinical investigations focused on therapy resistance in hematologic disorders. Topic editors: Christina Karantanou, Tsukuru Umemura, Maria Kourti Source: https://www.frontiersin.org/research-topics/73906/markers-of-therapy-resistance-in-hematologic-disorders