[Study on the Resistance Mechanism of Blinatumomab in the Treatment of Acute Lymphoblastic Leukemia--Review].

Blinatumomab is the first globally approved bispecific T cell engager targeting the B-cell surface antigen CD19, and numerous clinical trials have demonstrated its significant efficacy in B-acute lymphoblastic leukemia (B-ALL) patients. However, with its widespread application, the problem of drug resistance is gradually becoming apparent. The specific mechanisms of drug resistance mainly include antigen escape, lineage switch, immune checkpoint pathway dysregulation and T cell exhaustion. In this review, the mechanisms of resistance to blinatumomab in B-ALL are systematically described, and relevant therapeutic strategies targeting these resistance factors are summarized to provide a reference for clinical diagnosis and treatment.