This narrative review seeks to summarize chemotherapeutic regimens commonly used for patients with newly diagnosed Philadelphia (Ph) chromosome–negative B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in the frontline setting and to describe the latest clinical research using the bispecific T-cell–engaging immunotherapy blinatumomab in the first-line treatment setting. Current standard-of-care chemotherapeutic backbones for newly diagnosed Ph-negative BCP-ALL are based on the same overarching treatment principle: to reduce disease burden to undetectable levels and maintain lasting remission. The adult treatment landscape has progressively evolved following the adoption of pediatric-inspired regimens. However, these intense regimens are not tolerated by all, and high-risk patients still have inferior outcomes. Therefore, designing more effective and less toxic strategies remains key to further improving efficacy and safety outcomes. Overall, the treatment landscape is evolving in the frontline, and integration of blinatumomab into different standard frontline regimens may improve overall outcomes with a favorable safety profile.

本叙述性综述旨在总结新诊断的费城 （Ph） 染色体阴性 B 细胞前体急性淋巴细胞白血病 （BCP-ALL） 患者在一线环境中常用的化疗方案，并描述在一线治疗环境中使用双特异性 T 细胞参与免疫疗法 blinatumomab 的最新临床研究。目前针对新诊断的 Ph 阴性 BCP-ALL 的标准化疗支柱基于相同的总体治疗原则：将疾病负担降低到无法检测的水平并保持持久缓解。随着儿科方案的采用，成人治疗格局逐渐发展。然而，并非所有人都能耐受这些强化方案，高危患者的结局仍然较差。因此，设计更有效、毒性更小的策略仍然是进一步提高疗效和安全性结果的关键。总体而言，一线治疗的前景正在发生变化，将 blinatumomab 整合到不同的标准一线方案中可能会改善整体结果，并具有良好的安全性。