Proteasome inhibition has been recognized as a novel treatment modality in 
hematologic malignancies. Initially, the reversible proteasome inhibitor 
bortezomib demonstrated efficacy in multiple myeloma (MM), which supported its 
approval for relapsed and refractory MM in 2003. Later on, carfilzomib, a 
next-generation irreversible proteasome inhibitor was approved by the US FDA in 
July 2012 for relapsed/refractory MM. Currently, several other proteasome 
inhibitors are undergoing preclinical and clinical evaluation. The successes of 
proteasome inhibitors in MM are now being translated to other hematologic 
malignancies, including acute leukemia. The first clinical studies with 
bortezomib in leukemia revealed promising clinical activity, particularly when 
combined with conventional chemotherapeutics. In this review the position of 
proteasome inhibitors in acute leukemia treatment is summarized and discussed. 
Special focus is also attributed to immunoproteasome inhibitors. As a future 
perspective, it is anticipated that proteasome inhibitors may prove to be of 
added value in therapeutic interventions for acute leukemia.