ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v23i2.3031ppharm-2790Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWМладенческий острый лимфобластный лейкоз: опыт прошлого и терапия будущегоInfant Acute Lymphoblastic Leukemia: Past Experience and Future Therapyhttps://orcid.org/0009-0002-9423-2672ЕфремоваМ. Д.EfremovaMaria D.

Ефремова Мария Дмитриевна, студентка 

Москва 

student 

Moscow 

efremova8maria@mail.ruhttps://orcid.org/0000-0002-1469-2365ВалиевТ. Т.ValievTimur T.

Валиев Тимур Теймуразович, доктор медицинских наук, профессор, заведующий отделением детской онкологии и гематологии (химиотерапия гемобластозов) № 1 НИИ детской онкологии и гематологии 

115522, г. Москва, Каширское шоссе, д. 23 

телефон: +7 (499) 444-24-24 

MD, PhD

23, Kashirskoe shosse, Moscow, 115522 

+7 (499) 444-24-24 

timurvaliev@mail.ruРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова (Пироговский Университет)РоссияN.I. Pirogov Russian National Research Medical UniversityRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. БлохинаРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation2026310520262327280Copyright © Ефремова М.Д., Валиев Т.Т., 20262026Ефремова М.Д., Валиев Т.Т.Efremova M.D., Valiev T.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/2790

Младенческий острый лимфобластный лейкоз (ОЛЛ) — редкая и биологически уникальная форма злокачественных заболеваний крови у детей первого года жизни, характеризующаяся агрессивным клиническим течением и неблагоприятным прогнозом, особенно при наличии перестроек гена KMT2A. В статье представлен обзор современных данных о клинических, иммунологических и молекулярно-генетических особенностях младенческого ОЛЛ из предшественников В-клеток. Подробно рассмотрены механизмы эпигенетической дисрегуляции и потенциальные мишени для таргетной терапии. Обсуждены эволюция подходов к стратификации пациентов на группы риска, роль минимальной остаточной болезни, а также результаты международных кооперированных исследований, направленных на повышение эффективности лечения. Особое внимание уделено внедрению иммунотерапевтических препаратов — блинатумомаба и Т-клеток с химерным антигенным рецептором (CAR-Т) — их эффективности в контроле заболевания. Обсуждены ограниченная роль трансплантации гемопоэтических стволовых клеток и современные тенденции к сужению показаний к ее применению. В заключение подчеркнуто значение интеграции генетических и динамически изменяющихся лабораторных параметров для персонализации терапии и обозначены перспективы дальнейшего улучшения исходов лечения младенцев с данным заболеванием.

Infant acute lymphoblastic leukemia (ALL) is a rare and biologically unique form of hematologic malignancy occurring in children during the first year of life. It is characterized by an aggressive clinical course and unfavorable prognosis, particularly in the presence of KMT2A gene rearrangements. This article provides a review of current data on the clinical, immunological, and molecular-genetic features of B-cell precursor infant ALL. The mechanisms of epigenetic dysregulation and potential targets for targeted therapy are discussed in detail. The evolution of risk stratification approaches, the role of minimal residual disease, and the results of international collaborative studies aimed at improving treatment outcomes are reviewed. Particular attention is paid to the introduction of immunotherapeutic agents — blinatumomab and chimeric antigen receptor T-cells (CAR-T) — and their efficacy in disease control. The limited role of hematopoietic stem cell transplantation and current trends toward narrowing its indications are discussed. In conclusion, the importance of integrating genetic and dynamically changing laboratory parameters for treatment personalization is emphasized, and future perspectives for further improving outcomes in infants with this disease are outlined.

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The authors declare that there are no conflicts of interest present.