Blinatumomab in pediatric acute lymphoblastic leukemia: current and future use.

Further improvement in the outcome of ALL requires new approaches, such as immunotherapy.

ALL的治疗结果进一步改善需要新的方法，例如免疫治疗。

Blinatumomab, a bispecific antibody to CD3 and CD19, is approved by the U.S.

Blinatumomab是一种针对CD3和CD19的双特异性抗体，已获得美国食品药品监督管理局批准，用于成人和≥1个月龄儿童的B-ALL多药联合化疗的巩固阶段。

Food and Drug Administration for use in the consolidation phase of multi-agent chemotherapy for B-ALL in adults and children (aged ≥1 month).

美国食品药品监督管理局批准用于成人和儿童（≥1个月龄）B-ALL多药联合化疗的巩固治疗阶段。

Randomized studies in pediatric patients with B-ALL in the relapsed/refractory and frontline settings have shown that blinatumomab, when added to chemotherapy or used to replace intensive chemotherapy, results in better outcomes and fewer adverse effects than are observed with conventional chemotherapy alone.

在复发/难治性以及一线治疗的儿童B-ALL患者中进行的随机研究显示，当将blinatumomab添加到化疗中或用以替代强化化疗时，与单独使用传统化疗相比，可以带来更好的治疗结果和较少的不良反应。

Resistance to blinatumomab is associated with high ALL burden, CD19 loss/downregulation, and T-cell dysfunction, and its efficacy against extramedullary disease, especially in the central nervous system, is limited.

对blinatumomab的抗药性与高ALL负荷、CD19的丢失/下调以及T细胞功能障碍有关，其对髓外疾病的疗效，特别是在中枢神经系统中，是有限的。

In addition, the serum half-life of blinatumomab is short, necessitating continuous intravenous infusion, and it can cause distinct adverse effects such as cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and hypogammaglobulinemia.

此外，博纳吐单抗的血清半衰期短，需要持续静脉输注，并且可能会引起如细胞因子释放综合征、免疫效应细胞相关神经毒性综合征和低丙种球蛋白血症等明显的不良反应。

Therefore, medical staff require training in administering blinatumomab and monitoring its adverse effects.

因此，医护人员需要接受博纳吐单抗的给药和监测其不良反应的培训。

The development of subcutaneous administration of blinatumomab will make its delivery easier.

开发布林妥珠单抗的皮下给药方式将使其给药过程更加便捷。

Whether it is feasible to reduce or eliminate conventional chemotherapy by combining blinatumomab, other forms of immunotherapy, and molecular targeting therapy to improve outcomes while reducing adverse effects requires further evaluation in the frontline setting.

通过结合布林妥珠单抗、其他形式的免疫治疗和分子靶向治疗，是否有可能减少或消除常规化疗，并在改善治疗结果的同时减少不良反应，这需要在一线治疗环境中进一步评估。

Furthermore, longitudinal monitoring is necessary to evaluate the as-yet-unknown long-term adverse effects.

此外，需要进行纵向监测以评估目前尚不明确的长期不良反应。

Lastly, the experience obtained with blinatumomab in high-income countries should be expanded to low-/middle-income countries, where most of the global population reside and where the outcomes of ALL are suboptimal.

最后，应在低收入和中等收入国家扩大使用blinatumomab的经验，这些国家居住着全球大部分人口，在这些国家中，急性淋巴细胞白血病（ALL）的治疗结果往往不佳。