急性髓系细胞白血病（AML）的增殖不仅抑制了正常造血作用，还改变了骨髓微环境。骨髓中不同组分的相互作用导致代谢状态的改变，并激活信号通路，从而引起抗药性并阻碍有效治疗。因此，这些潜在的过程和机制成为克服AML治疗抗药性的吸引人的治疗策略。本文简要讨论了基于细胞相互作用和分泌可溶性因子的抗药性机制，并概述了目前正在进行临床前和临床研究的与造血细胞生长环境相关的治疗靶点，这些靶点有望改善AML治疗的预后。© 2023 作者。癌症国际期刊由John Wiley & Sons Ltd代表UICC出版。

The expansion of acute myeloid leukemia (AML) blasts not only suppresses normal hematopoiesis, but also alters the microenvironment. The interplay of different components of the bone marrow gives rise to altered metabolic states and activates signaling pathways which lead to resistance and impede effective therapy. Therefore, the underlying processes and mechanisms represent attractive therapeutic leverage points for overcoming therapy resistance in AML. Here, we briefly discuss resistance mechanisms based on cell interactions and secreted soluble factors in the hematopoietic niche and provide an overview of niche-related therapeutic targets currently undergoing preclinical and clinical investigation which may help improve the outcome in AML therapy.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.