Extensive research on the CXCL12-CXCR4 axis in acute myeloid leukemia (AML) has resulted in the incorporation of novel anti-leukemia drugs targeting this axis into therapeutic strategies. However, despite this progress, a comprehensive and up-to-date review addressing the role of the CXCL12-CXCR4 axis in AML’s oncogenic processes is lacking. In this review, we examine its molecular aspects influencing cancer progression, such as its impact on autonomous proliferation, apoptotic regulation, chemoresistance mechanisms, and interactions with non-leukemic cells such as MSCs and T_reg cells. Additionally, we explore clinical implications, including prognosis, correlation with WBC count, blast count in the bone marrow and peripheral blood, as well as its association with FLT3-ITD, NPM1 mutations, and FAB classification. Finally, this paper extensively discusses drugs that specifically target the CXCL12-CXCR4 axis, including plerixafor/AMD3100, ulocuplumab, peptide E5, and motixafortide, shedding light on their potential therapeutic value in the treatment of AML.

对急性髓性白血病 （AML） 中 CXCL12-CXCR4 轴的广泛研究导致将靶向该轴的新型抗白血病药物纳入治疗策略。然而，尽管取得了这些进展，但缺乏解决 CXCL12-CXCR4 轴在 AML 致癌过程中的作用的全面和最新的综述。在这篇综述中，我们研究了其影响癌症进展的分子方面，例如它对自主增殖、凋亡调节、化疗耐药机制以及与非白血病细胞（如 MSC 和 T_reg 细胞）相互作用的影响。此外，我们还探讨了临床意义，包括预后、与 WBC 计数的相关性、骨髓和外周血中的原始细胞计数，以及它与 FLT3-ITD 、 NPM1 突变和 FAB 分类的相关性。最后，本文广泛讨论了专门靶向 CXCL12-CXCR4 轴的药物，包括 plerixafor/AMD3100、ulocuplumab、肽 E5 和 motixafortide，阐明了它们在治疗 AML 中的潜在治疗价值。