急性白血病的特点是克隆异质性，导致患者药物反应不佳。尽管治疗取得了进展，但复发的发生仍然是实现治愈的主要障碍，因为当前的治疗方法不足以有效预防或克服耐药性。鉴于只有少数基因突变与急性白血病患者的复发有关，人们越来越关注影响癌症特征以使白血病细胞在治疗后存活的“非遗传”机制。在这篇综述中，我们概述了急性白血病的治疗前景。重要的是，我们讨论了白血病细胞利用非遗传机制来促进其治疗后的存活。最后，我们提出了预防或克服这种疾病耐药性的当前策略。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Acute leukemia is characterized by clonal heterogeneity that contributes to poor drug responses in patients. Despite treatment advances, the occurrence of relapse remains a major barrier to achieving cures as current therapeutic approaches are inadequate to effectively prevent or overcome resistance. Given that only a few genetic mutations are associated with relapse in acute leukemia patients, there is a growing focus on 'non-genetic' mechanisms that affect the hallmarks of cancer to allow leukemic cells to survive post therapy. In this review, we provide an overview of the therapeutic landscape in acute leukemias. Importantly, we discuss non-genetic mechanisms exploited by leukemic cells to promote their survival after treatment. Last, we present current strategies to prevent or overcome drug resistance in this disease.Copyright © 2023 Elsevier Inc. All rights reserved.