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Abstract
Background: Leukemia is a complicated blood cancer that is characterized by immune dysfunction and thrombo-inflammation. The cross-linkage of platelet neutrophils, especially with the help of NETs and adhesion cues, promotes disease development, thrombosis, immune surveillance, and treatment resistance.
Objective: To establish the platelet neutrophil interaction in the pathophysiology and progression of leukemia.
Methodology: A structured-literature review was performed, which is a systematic-search procedure in the form of narrative. Peer-reviewed articles published between January 2020 and December 2025. Original research papers, systematic reviews, and high-quality narrative reviews were captured and conference abstracts without the full text and irrelevant editorials were not.
Results: The activation of platelets facilitates neutrophil recruitment and neutrophil NET through PSGL-1 and P-selectin. High NETs cause immunothrombosis, endothelial injury and leukemic progression. Platelet-derived factors also increase the survival, chemoresistance of leukemic cells, and are associated with poor clinical outcomes.
Conclusion: Platelet-neutrophil cross talk leads to inflammation, coagulation and leukemia development. Overproduction of platelet activation and NET release produces an immunosuppressive, prothrombotic environment that is disease sustaining. This pathway should be targeted to enhance the results in leukemia.