Integrating 3D culture systems and gene editing technologies for precision medicine in hematological malignancies

Authors

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260654

Keywords:

3D culture, Hematological malignancy, Gene editing, Tumour interaction, Extra-cellular matrix, Tumour microenvironment

Abstract

Haematological malignancies comprise a diverse group of life-threatening systemic diseases in the blood, bone marrow, and lymphoid tissues, and their progression is strongly influenced by a supportive tumour microenvironment that drives proliferation and drug resistance. Drug development and personalised treatment using patient-derived cells are a tedious and expensive process, often conducted in 2D cell culture, which has many uncertainties and limitations due to poor mimicry of the microenvironment, cellular mechanisms, and morphological changes. Animal models also fail to fully replicate human pathobiology and are time-consuming. Alternatively, three-dimensional (3D) in vitro tissue modelling techniques can replicate the complex microenvironment, resembling the morphology, cell-cell interactions, and extracellular matrix (ECM) through methods like organoids, spheroids, tumoroids, and scaffold-based cultures. High-throughput drug screening in edited 3D cultures allows analysis of tumour interactions in haematological malignancies, for example, assessing gene-mediated drug resistance in AML within the marrow niche, depending on specific myeloma plasma cell cultures and their interactions with mesenchymal stem cells, along with susceptibility to CAR-T regulators and clinical translation in patient-derived therapies. The clinical translation of 3D culture and gene-editing–based in vitro models in leukemia, lymphoma, and multiple myeloma predicts cellular interactions with the tumour microenvironment, thereby enabling targeted treatment options for patients. This review highlights current progress in integrating gene editing with 3D culture system and emphasises their potential to enhance personalised drug discovery and preclinical testing in haematological malignancies.

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References

Gezici S. Molecular mechanisms of immune checkpoints as an immunotherapy tool in hematological malignancies. In: Rezaei N, editor. Comprehensive haematology and stem cell research. 1st edition. Elsevier. 2024:366-72. DOI: https://doi.org/10.1016/B978-0-443-15717-2.00035-4

Adams TL, Latham GJ, Eisses MJ, Bender MA, Haberkern CM. Essentials of hematology. In: Coté CJ, Lerman J, Anderson BJ, editors. A practice of anesthesia for infants and children. 6th edition. Elsevier. 2019:217-39.e8. DOI: https://doi.org/10.1016/B978-0-323-42974-0.00010-0

Erickson RP. Somatic gene mutation and human disease other than cancer. Mutat Res. 2003;543:125-36. DOI: https://doi.org/10.1016/S1383-5742(03)00010-3

Furutani E, Shimamura A. Germline genetic predisposition to hematologic malignancy. J Clin Oncol. 2017;35:1018-28. DOI: https://doi.org/10.1200/JCO.2016.70.8644

Mehrpouri M, Pourbagheri-Sigaroodi A, Bashash D. The contributory roles of histone deacetylases (HDACs) in hematopoiesis regulation and possibilities for pharmacologic interventions in hematologic malignancies. Int Immunopharmacol. 2021;100:108114. DOI: https://doi.org/10.1016/j.intimp.2021.108114

Chennamadhavuni A, Iyengar V, Mukkamalla SKR, et al. Leukemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025.

Tebbi CK. Etiology of Acute Leukemia: A Review. Cancers (Basel). 2021;13(9):2256. DOI: https://doi.org/10.3390/cancers13092256

Lewis WD, Lilly S, Jones KL. Lymphoma: diagnosis and treatment. Am Fam Physician. 2020;101(1):34-41.

Ullah F, Dima D, Omar N, Ogbue O, Ahmed S. Advances in the treatment of Hodgkin lymphoma: Current and future approaches. Front Oncol. 2023;13:1067289. DOI: https://doi.org/10.3389/fonc.2023.1067289

Diefenbach CS, Connors JM, Friedberg JW, Leonard JP, Kahl BS, Little RF, et al. Hodgkin Lymphoma: Current Status and Clinical Trial Recommendations. J Natl Cancer Inst. 2016;109(4):djw249. DOI: https://doi.org/10.1093/jnci/djw249

Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. 3rd ed. Lyon: International Agency for Research on Cancer. 2001;3. Available at: https://publications.iarc.who.int/Book-And-Report-Series/Who-Classification-Of-Tumours/Pathology-And-Genetics-Of-Tumours-Of-Haematopoietic-And-Lymphoid-Tissues-2001. Accessed on 20 December 2025

Dima D, Jiang D, Singh DJ, Hasipek M, Shah HS, Ullah F, et al. Multiple myeloma therapy: emerging trends and challenges. Cancers (Basel). 2022;14(17):4082. DOI: https://doi.org/10.3390/cancers14174082

Rajkumar SV, Buadi F. Multiple myeloma: new staging systems for diagnosis, prognosis and response evaluation. Best Pract Res Clin Haematol. 2007;20(4):665-80. DOI: https://doi.org/10.1016/j.beha.2007.10.002

Jagannath S. Pathophysiological underpinnings of multiple myeloma progression. J Manag Care Pharm. 2008;14:7-11. DOI: https://doi.org/10.18553/jmcp.2008.14.S7-A.7

Jubelin C, Muñoz-Garcia J, Griscom L, Cochonneau D, Ollivier E, Heymann MF, et al. Three-dimensional in vitro culture models in oncology research. Cell Biosci. 2022;12(1):155. DOI: https://doi.org/10.1186/s13578-022-00887-3

Gopal S, Rodrigues AL, Dordick JS. Exploiting CRISPR-Cas9 in three-dimensional stem cell cultures to model disease. Front Bioeng Biotechnol. 2020;8:692. DOI: https://doi.org/10.3389/fbioe.2020.00692

Kapałczyńska M, Kolenda T, Przybyła W, Zajączkowska M, Teresiak A, Filas V, et al. 2D and 3D cell cultures - a comparison of different types of cancer cell cultures. Arch Med Sci. 2018;14:910-9.

Edmondson R, Broglie JJ, Adcock AF, Yang L. Three-dimensional cell culture systems and their applications in drug discovery and cell-based biosensors. Assay Drug Dev Technol. 2014;12:207-18. DOI: https://doi.org/10.1089/adt.2014.573

Langhans SA. Three-dimensional in vitro cell culture models in drug discovery and drug repositioning. Front Pharmacol. 2018;9:6. DOI: https://doi.org/10.3389/fphar.2018.00006

Rungarunlert S, Techakumphu M, Pirity MK, Dinnyes A. Embryoid body formation from embryonic and induced pluripotent stem cells: benefits of bioreactors. World J Stem Cells. 2009;1:11-21. DOI: https://doi.org/10.4252/wjsc.v1.i1.11

Tekin H, Simmons S, Cummings B, Gao L, Adiconis X, Hession CC, et al. Effects of 3D culturing conditions on the transcriptomic profile of stem-cell-derived neurons. Nat Biomed Eng. 2018;2:540-54. DOI: https://doi.org/10.1038/s41551-018-0219-9

Fong AH, Romero-López M, Heylman CM, Keating M, Tran D, Sobrino A, et al. Three-dimensional adult cardiac extracellular matrix promotes maturation of human induced pluripotent stem cell-derived cardiomyocytes. Tissue Eng Part A. 2016;22:1016-25. DOI: https://doi.org/10.1089/ten.tea.2016.0027

Sutherland RM, Inch WR, McCredie JA, Kruuv J. A multi-component radiation survival curve using an in vitro tumour model. Int J Radiat Biol Relat Stud Phys Chem Med. 1970;18:491-5. DOI: https://doi.org/10.1080/09553007014551401

Lehmann R, Lee CM, Shugart EC, Benedetti M, Charo RA, Gartner Z, et al. Human organoids: a new dimension in cell biology. Mol Biol Cell. 2019;30:1129-37. DOI: https://doi.org/10.1091/mbc.E19-03-0135

Finnberg NK, Gokare P, Lev A, Grivennikov SI, MacFarlane AW 4th, Campbell KS, et al. Application of 3D tumoroid systems to define immune and cytotoxic therapeutic responses based on tumoroid and tissue slice culture molecular signatures. Oncotarget. 2017;8(40):66747-57. DOI: https://doi.org/10.18632/oncotarget.19965

Shalem O, Sanjana NE, Zhang F. High-throughput functional genomics using CRISPR-Cas9. Nat Rev Genet. 2015;16(5):299-311. DOI: https://doi.org/10.1038/nrg3899

Drost J, Clevers H. Organoids in cancer research. Nat Rev Cancer. 2018;18(7):407-18. DOI: https://doi.org/10.1038/s41568-018-0007-6

Shin JW, Mooney DJ. Extracellular matrix stiffness causes systematic variations in proliferation and chemosensitivity in myeloid leukemias. Proc Natl Acad Sci U S A. 2016;113:12126. DOI: https://doi.org/10.1073/pnas.1611338113

Sirenko O, Mitlo T, Hesley J, Luke S, Owens W, Cromwell EF. High-content assays for characterizing the viability and morphology of 3D cancer spheroid cultures. Assay Drug Dev Technol. 2015;13:402-14. DOI: https://doi.org/10.1089/adt.2015.655

Miraki-Moud F, Anjos-Afonso F, Hodby KA, Griessinger E, Rosignoli G, Lillington D, et al. Acute myeloid leukemia does not deplete normal hematopoietic stem cells but induces cytopenias by impeding their differentiation. Proc Natl Acad Sci U S A. 2013;110(33):13576-81. DOI: https://doi.org/10.1073/pnas.1301891110

Roccaro AM, Sacco A, Maiso P, Azab AK, Tai YT, Reagan M, et al. BM mesenchymal stromal cell-derived exosomes facilitate multiple myeloma progression. J Clin Invest. 2013;123(4):1542-55. DOI: https://doi.org/10.1172/JCI66517

Aljitawi OS, Li D, Xiao Y, Zhang D, Ramachandran K, Stehno-Bittel L, et al. A novel three-dimensional stromal-based model for in vitro chemotherapy sensitivity testing of leukemia cells. Leuk Lymphoma. 2014;55(2):378-91. DOI: https://doi.org/10.3109/10428194.2013.793323

Hughes TP, Shanmuganathan N. Management of TKI-resistant chronic phase CML. Hematology Am Soc Hematol Educ Program. 2022;2022(1):129-37. DOI: https://doi.org/10.1182/hematology.2022000328

Chen Y, Xie X, Wu A, Wang L, Hu Y, Zhang H, Li Y. A synthetic cell-penetrating peptide derived from nuclear localization signal of EPS8 exerts anticancer activity against acute myeloid leukemia. J Exp Clin Cancer Res. 2018;37(1):12. DOI: https://doi.org/10.1186/s13046-018-0682-x

Assaraf YG, Brozovic A, Gonçalves AC, Jurkovicova D, Linē A, Machuqueiro M, et al. The multi-factorial nature of clinical multidrug resistance in cancer. Drug Resist Updat. 2019;46:100645. DOI: https://doi.org/10.1016/j.drup.2019.100645

Hanahan D, Coussens LM. Accessories to the crime: functions of cells recruited to the tumor microenvironment. Cancer Cell. 2012;21(3):309-22. DOI: https://doi.org/10.1016/j.ccr.2012.02.022

Kitaeva KV, Rutland CS, Rizvanov AA, Solovyeva VV. Cell culture based in vitro test systems for anticancer drug screening. Front Bioeng Biotechnol. 2020;8:322. DOI: https://doi.org/10.3389/fbioe.2020.00322

Hirata E, Sahai E. Tumor microenvironment and differential responses to therapy. Cold Spring Harb Perspect Med. 2017;7(7):a026781. DOI: https://doi.org/10.1101/cshperspect.a026781

Houshmand M, Soleimani M, Atashi A, Saglio G, Abdollahi M, Nikougoftar Zarif M. Mimicking the acute myeloid leukemia niche for molecular study and drug screening. Tissue Eng Part C Methods. 2017;23(2):72-85. DOI: https://doi.org/10.1089/ten.tec.2016.0404

Torres-Barrera P, Moreno-Lorenzana D, Alvarado-Moreno JA, García-Ruiz E, Lagunas C, Mayani H, et al. Cell contact with endothelial cells favors the in vitro maintenance of human chronic myeloid leukemia stem and progenitor cells. Int J Mol Sci. 2022;23(18):10326. DOI: https://doi.org/10.3390/ijms231810326

Bray LJ, Binner M, Körner Y, von Bonin M, Bornhäuser M, Werner C. A three-dimensional ex vivo tri-culture model mimics cell-cell interactions between acute myeloid leukemia and the vascular niche. Haematologica. 2017;102(7):1215-26. DOI: https://doi.org/10.3324/haematol.2016.157883

Damiano JS, Cress AE, Hazlehurst LA, Shtil AA, Dalton WS. Cell adhesion mediated drug resistance (CAM-DR): role of integrins and resistance to apoptosis in human myeloma cell lines. Blood. 1999;93(5):1658-67. DOI: https://doi.org/10.1182/blood.V93.5.1658

Asimakopoulos F, Hope C, Johnson MG, Pagenkopf A, Gromek K, Nagel B. Extracellular matrix and the myeloid-in-myeloma compartment: balancing tolerogenic and immunogenic inflammation in the myeloma niche. J Leukoc Biol. 2017;102(2):265-75. DOI: https://doi.org/10.1189/jlb.3MR1116-468R

Ybarra M, Lee J, Chen YY, Lin J, Zhao J, Ma C. Human preclinical multiple myeloma in vitro models for disease modeling and therapy screening. J Biol Eng. 2025;19(1):98. DOI: https://doi.org/10.1186/s13036-025-00570-4

Bahlmann LC, Xue C, Chin AA, Skirzynska A, Lu J, Thériault B, et al. Targeting tumour-associated macrophages in Hodgkin lymphoma using engineered extracellular matrix-mimicking cryogels. Biomaterials. 2023;297:122121. DOI: https://doi.org/10.1016/j.biomaterials.2023.122121

Mastini C, Campisi M, Patrucco E, Mura G, Ferreira A, et al. Targeting CCR7-PI3Kgamma overcomes resistance to tyrosine kinase inhibitors in ALK-rearranged lymphoma. Sci Transl Med. 2023;15:3826. DOI: https://doi.org/10.1126/scitranslmed.abo3826

Nourmohammadi H, Babashahi M, Panji M, Radmehr S. Gene-edited hematopoietic stem cells for leukemia and lymphoma treatment: a systematic review of preclinical and translational evidence. Discov Oncol. 2025;16(1):1804. DOI: https://doi.org/10.1007/s12672-025-03529-5

Wang J, Feng X, Li Z, Chen Y, Huang W. Patient-derived organoids as a model for tumor research. Prog Mol Biol Transl Sci. 2022;189(1):259-326. DOI: https://doi.org/10.1016/bs.pmbts.2022.03.004

Provasi E, Genovese P, Lombardo A, Magnani Z, Liu PQ, Reik A, et al. Editing T cell specificity towards leukemia by zinc finger nucleases and lentiviral gene transfer. Nat Med. 2012;18(5):807-15. DOI: https://doi.org/10.1038/nm.2700

Costa EC, Moreira AF, de Melo-Diogo D, Gaspar VM, Carvalho MP, Correia IJ. 3D tumor spheroids: an overview on the tools and techniques used for their analysis. Biotechnol Adv. 2016;34(8):1427-41. DOI: https://doi.org/10.1016/j.biotechadv.2016.11.002

Fang Y, Eglen RM. Three-dimensional cell cultures in drug discovery and development. SLAS Discov. 2017;22(5):456-72. DOI: https://doi.org/10.1177/1087057117696795

Gunness P, Mueller D, Shevchenko V, Heinzle E, Ingelman-Sundberg M, Noor F. 3D organotypic cultures of human HepaRG cells: a tool for in vitro toxicity studies. Toxicol Sci. 2013;133(1):67-78. DOI: https://doi.org/10.1093/toxsci/kft021

Ivanov DP, Grabowska AM. Spheroid arrays for high-throughput single-cell analysis of spatial patterns and biomarker expression in 3D. Sci Rep. 2017;7:41160. DOI: https://doi.org/10.1038/srep41160

Van Lidth de Jeude JF, Vermeulen JL, Montenegro-Miranda PS, Van den Brink GR, Heijmans J. A protocol for lentiviral transduction and downstream analysis of intestinal organoids. J Vis Exp. 2015;98:52531. DOI: https://doi.org/10.3791/52531-v

Hustedt N, Durocher D. The control of DNA repair by the cell cycle. Nat Cell Biol. 2016;19(1):1-9. DOI: https://doi.org/10.1038/ncb3452

Schwank G, Andersson-Rolf A, Koo BK, Sasaki N, Clevers H. Generation of BAC transgenic epithelial organoids. PLoS One. 2013;8(10):e76871. DOI: https://doi.org/10.1371/journal.pone.0076871

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Published

2026-02-26

How to Cite

Dhanasekar, S., Meenakumari, B., Kathirvel, B., & Chandramouleeswari, K. (2026). Integrating 3D culture systems and gene editing technologies for precision medicine in hematological malignancies. International Journal of Research in Medical Sciences, 14(3), 1266–1276. https://doi.org/10.18203/2320-6012.ijrms20260654

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Review Articles