Acute lymphoblastic leukemia (ALL) is one of the common malignant tumors. Compared with childhood ALL, the treatment effect of adult B-cell ALL is less effective and remains a big challenge. In order to explore the pathogenesis of adult B-cell ALL and find new diagnostic biomarkers to develop sensitive diagnostic tools, we investigated the plasma metabolites of adult B-cell ALL by using 1H NMR (nuclear magnetic resonance) metabolomics. Relative to healthy controls, adult B-cell ALL patients showed abnormal metabolism, including glycolysis, gluconeogenesis, amino acid metabolism, fatty acid metabolism and choline phospholipid metabolism. What's more important, we also found that the optimal combination of choline, tyrosine and unsaturated lipids has the potential to diagnose and prognose adult B-cell ALL in the clinic.