尽管随着近年分子遗传学和疾病发病机制的深入研究，干细胞移植、免疫治疗、靶向治疗以及单克隆抗体等新的治疗手段不断出现，急性淋巴细胞白血病(ALL)的治愈率和生存率有了显著改善，但是复发/难治性ALL的治疗仍是难点。了解ALL的潜在发病机制，特别是相关的表观遗传改变，对开发有前景的治疗策略具有重要意义。本综述重点关注ALL中的表观遗传改变，包括DNA甲基化、组蛋白修饰和miRNA改变，期望可以为ALL的个体化治疗和精确治疗提供新的思路。Although new treatment methods such as stem cell transplantation, immunotherapy, targeted therapy and monoclonal antibodies have emerged in recent years with in-depth research on molecular genetics and disease pathogenesis, the cure rate and survival rate of acute lymphoblastic leukemia (ALL) have significantly improved. However, the treatment of relapsed/refractory ALL is still a difficult problem. Understanding the underlying mechanisms of ALL, especially the related epigenetic alterations, is of great significance for developing promising treatment strategies. This review mainly focuses on epigenetic changes in ALL, including DNA methylation, histone modification, and miRNA alterations, with the aim of providing new ideas for individualized and precise treatment of ALL.