虽然小儿血癌是致命的，但现代医学的进步使临床医生能够测量残留癌细胞的水平，以管理患者的治疗策略。然而，包括白血病和淋巴瘤在内的血癌具有高度异质性，并且由复杂的克隆群体组成，这可能会阻碍检测癌细胞和管理治疗的努力。此外，肿瘤微环境由异质免疫动力学组成，患者之间可能有所不同。高通量测序为癌症（包括血癌）的遗传和转录组改变的新发现做出了贡献，并改变了患者的监测和管理方式。在这里，我们讨论最近使用单细胞方法所做的努力，特别是追踪儿科血癌克隆异质性和潜在免疫反应的努力，强调了可能对临床肿瘤学实践产生重大影响的新型生物标志物发现途径。© 2024 作者（ s）。约翰·威利出版的《临床与转化医学》

While paediatric blood cancers are deadly, modern medical advances have enabled clinicians to measure levels of residual cancer cells to manage therapeutic strategies for patients. However, blood cancers, including leukaemias and lymphomas, are highly heterogeneous and is comprised of complex clonal populations that can hinder efforts in detecting the cancer cells as well as managing treatments. Furthermore, the tumour microenvironment is comprised of heterogenous immune dynamics that may be different between patients. High-throughput sequencing has constributed to new discoveries in genetic and transcriptomic alterations underpinning cancer, including blood cancers, and has changed how patients are monitored and managed. Here we discuss the recent efforts using single-cell approach, particularly on efforts to track clonal heterogenity of paediatric blood cancer and the underlying immune response, highlighting avenues for novel biomarker discovery that may have significant impact on clinical oncology practice.© 2024 The Author(s). Clinical and Translational Medicine published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.