The survival rate of children and adolescents with acute lymphoblastic leukemia (ALL), the most common pediatric cancer, has improved significantly in high-income countries (HICs), serving as an excellent example of how humans can overcome catastrophic diseases. However, the outcomes in children with ALL in low- and middle-income countries (LMICs), where approximately 80% of the global population live, are suboptimal because of limited access to diagnostic procedures, chemotherapeutic agents, supportive care, and financial assistance. Although the implementation of therapeutic strategies in resource-limited countries could theoretically follow the same path of improvement as modeled in HICs, intensification of chemotherapy may simply result in increased toxicities. With the advent of genetic diagnosis, molecular targeted therapy, and immunotherapy, the management of ALL is changing dramatically in HICs. Multidisciplinary collaborations between institutions in LMICs and HICs will provide access to strategies that are suitable for institutions in LMICs, enabling them to minimize toxicities while improving outcomes. This article summarizes important aspects of the diagnosis and treatment of pediatric ALL that were mostly developed in HICs but that can be realistically implemented by institutions in countries with limited resources through resource-adapted multidisciplinary collaborations.

急性淋巴细胞白血病 （ALL） 是最常见的儿科癌症，儿童和青少年的存活率在高收入国家 （HIC） 显著提高，是人类如何战胜灾难性疾病的一个很好的例子。然而，由于获得诊断程序、化疗药物、支持性护理和经济援助的机会有限，全球约 80% 的低收入国家 （LMIC） 的 ALL 儿童预后并不理想。尽管在资源有限国家实施治疗策略理论上可以遵循与 HIC 相同的改进路径，但化疗的强化可能只会导致毒性增加。随着基因诊断、分子靶向治疗和免疫治疗的出现，HIC 中 ALL 的管理正在发生巨大变化。低收入和中等收入国家和高收入国家机构之间的多学科合作将提供适合低收入和中等收入国家机构的策略，使它们能够在改善结果的同时最大限度地减少毒性。本文总结了儿科 ALL 诊断和治疗的重要方面，这些方面主要在 HIC 中开发，但可以通过资源适应的多学科合作由资源有限国家的机构实际实施。