Exploring the applicability, combined strategies, and challenges of ablation in hematology based on its characteristics and immunomodulatory mechanisms

Malignant hematological diseases, such as lymphoma, leukemia, and multiple myeloma, are frequently accompanied by clinical challenges including local progressive lesions, relapsed/refractory conditions, and poor tolerance to standard treatments in special populations. Systemic therapies represented by chemotherapy and targeted therapy have inherent limitations in addressing local tumor burden, relieving organ compression, and being suitable for frail patients. As a minimally invasive local treatment technology, ablation has been widely used in solid tumor therapy due to its advantages of precise targeting, controllable tissue damage, and potential immune activation. However, its application in hematological diseases remains scattered and lacks systematic integration. This review focuses on three mainstream ablation technologies—radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA)—systematically elaborating their core mechanisms, technical advancements, and clinical applications in hematological diseases. We analyze the clinical value of ablation in reducing tumor burden, relieving symptoms, adapting to special populations, intervening in myeloma bone disease, and treating aspergilloma. Additionally, we clarify the indications and contraindications of ablation in hematological diseases. We also discuss in depth the current challenges, including insufficient evidence, technical application boundaries, and limited immunomodulatory effects. Finally, we explore the future development directions of ablation technology in this field from the aspects of clinical evidence construction, treatment strategy optimization—such as combinations with immunotherapy and nanomedicine—and technical popularization and standardization. This review aims to provide a comprehensive theoretical basis and practical reference for the clinical application and in-depth research of ablation technology in hematological diseases.