The clinical materials of twenty patients with newly treated and refractory recurrent Ph⁺ALL were analyzed retrospectively. After induction treatment with tyrosine kinase inhibitor+vincristine+prednisone（TKI+VP） or tyrosine kinase inhibitor+vincristine+daunorubicin+prednisone（TKI+VDP），17 patients achieved hematological complete remission（HCR） and 3 patients did no remission （NR）. Among the HCR patients， 8 patients for minimal residual disease （MRD） were negative， 3 patients chose Auto-HSCT， and all received TKI maintenance treatment till now after hematopoietic function reconstruction； Allogeneic hematopoietic stem cell transplantation （Allo-HSCT） was performed in other 5 MRD negative patients， 9 MRD positive patients and 3 NR patients.The BCR/ABL fusion genes in the peripheral blood of the patients were detected before transplantation，1 month and 2，3，6，9，and 12 months after stem cell transplantation，and the MRD of the patients was evaluated.After hematopoietic reconstruction in Allo-HSCT group， TKI oral intervention was given regardless of the results of BCR/ABL gene quantitative detection. TKI oral intervention was discontinued after one year for those who continued to test negative. If positive MRD conversion was monitored during the period， effective TKI drugs or immunosuppressant reduction， and other therapeutic measures were given according to the time of transplantation.

All patients achieved hematopoietic reconstruction after transplantation， the median survival time of granulocyte transplantation was 14 （11－24） d， and the median survival time of platelet transplantation was 17 （13－52） d. Follow-up was conducted until December 2020， with a median follow-up time of 52 （3－111） months.The 3-year overall survival （OS） rates of all the patient was （61.1±11.7）%. The 3-year OS rates in Allo-HSCT group and Auto-HSCT group were （52.8±13.4）% and 100.0% （P=0.178），respectively， and the difference was not statistically significant（P=0.178）.The 3-year OS rates of the patients in MRD negative group before treatment and MRD positive group with HCR before treatment were （87.5±11.7）% and （42.8± 15.6）% （P=0.065）， respectively，and the difference was not statistically significant（P=0.065）.All patients with NR before transplantation died.Five cases in whole group died of disease recurrence，1 case of lung infection and 1 case of grade Ⅳ acute graft-versus-host disease.

In the patients with Ph⁺ALL， choosing autologous or allogeneic hematopoietic stem cell transplantation and postoperative stratified intervention according to the dynamic changes of BCR/ABL fusion gene results can improve the OS rate of patients.