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Exosome, a major component of extracellular vesicles, is an important media for intercellular communications under physiological conditions. In a variety of hematological malignancies researches, it has been demonstrated that exosome acts as the key carrier for interactions among the components of the bone marrow microenvironment. Due to its widespread existence and containing specific nucleic acid and protein molecules, the importance of exosome as a potential biomarker and therapeutic target/carrier in the diagnosis and treatment of hematological malignancies has been attracting more attention in the past few years.