Abstract: By multiple means，the great progress has been made in the therapy of pediatric acute leukemia. But the relapse occurred after chemotherapy，allo-hematopoietic stem cell transplantation or Chimeric Antigen Receptor T-Cell Immunotherapy，which remained difficult to handle. The immune escape was revealed to play important role in the acute leukemia relapse. The leukemic cells evaded the immune surveillance and clearance to achieve the survival and proliferation leading to the relapse，especially in bone marrow microenvironment. T cell exhaustion was indicated to be critical in the immune escape. T cell exhaustion described a poor functional state，usually observed in chronic inflammation and tumor progress. We depicted here the research of T cell exhaustion in the relapsed acute leukemia of children，exploring the new strategy to handling the relapse by targeting it.

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摘要： 随着多种治疗方法的发展及联合应用，儿童急性白血病的治疗已取得了极大进展，包括化疗、造血干细胞移植或嵌合抗原受体T细胞在内的多种治疗后复发是当前儿童急性白血病的治疗难题。免疫学进展揭示了免疫逃逸在急性白血病复发中的重要作用，白血病细胞以多种机制逃避免疫系统的识别和攻击得以存活和增殖最终导致复发、病情进展。研究表明，T细胞耗竭在急性白血病的免疫逃逸中发挥了关键作用。T细胞耗竭是一种 T 细胞功能低下的状态，常出现在慢性感染和肿瘤进展中。该文将概述T细胞耗竭在儿童急性白血病复发中的研究现状，展望通过靶向T细胞耗竭治疗急性白血病复发的新策略。

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