In the treatment of childhood Ph+ALL, TKI-combined chemotherapy has become the standard option, and HSCT in first remission is no longer an absolute indication. However, pediatric Ph+ALL is still a refractory leukemia, and 5-year EFS in children without HSCT in first remission was only 55-60% because of treatment-related death and post-chemotherapy relapse. Further improvement in clinical outcomes may require intensified targeted therapy in combination with low-intensity chemotherapy and/or immune antibody therapy with reduced toxicity. Continuing to address these challenges in prospective clinical studies will change childhood Ph+ALL from refractory leukemia to more manageable leukemia in the future.
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