探讨ABL1酪氨酸激酶抑制剂（TKIs）的依从性对染色体阳性（Ph+）急性淋巴细胞白血病（ALL）儿童的存活影响，澄清TKIs服用实践中患者预后的潜在预测因素。招募了90名接受TKIs治疗的新诊断Ph+ ALL患儿。我们收集了所有儿童的基线特征和不良事件（AEs）；此外，通过Morisky药物依从性量表（MMAS-8）的八个项目来测量TKIs的依从性。进行了无进展生存期（PFS）和总生存期（OS）分析，并评估了PFS和OS的风险因素。 在所有患者中，有69例被视为依从者，而21例为非依从者。TKIs中断的中位数持续时间在非依从组中显著长于依从组[13（0-101）比56（11-128），P＜0.001]。此外，减量发生在55.2％的非依从者与23.0％的依从者（p = 0.002）中。依从者的PFS和OS显著高于非依从者（P = 0.020和P = 0.039）。MMAS-8得分是PFS（p = 0.010）和OS（p = 0.031）的独立危险因素。在非依从者中，≤10岁的患者的中位OS仅为23.1％（4.2-42％），而在青少年中为54.4％（38.8-70％）。大多数经历TKIs非依从的患者都患有全血细胞减少症。 治疗期间TKIs的依从性显著影响了儿科Ph+ ALL患者的存活率，而年龄≤10岁的非依从者更容易出现TKIs中断。应特别强调累积的TKIs剂量对≤10岁的患者，这可能导致相关治疗里程碑的达成不足。

To explore the impact of ABL1-tyrosine kinase inhibitors (TKIs) adherence on the survival of chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) children and clarify the potential predictors of patients' prognosis from TKIs intake practices.Ninety newly diagnosed Ph+ ALL patients who received TKIs were enrolled. We collected the baseline characteristics and adverse events (AEs) in all children; moreover, TKIs adherence was measured by an eight-item Morisky medication adherence scale (MMAS-8). Progression-free survival (PFS) and overall survival (OS) analysis were performed, and risk factors for PFS and OS were evaluated.Among all patients, 69 cases were regarded as adherers, while 21 were non-adherers. The median duration of TKIs interruption was significantly prolonged in the non-adherence group than in the adherence group [13 (0-101) vs. 56 (11-128), p<0.001]. Additionally, dose reduction occurred in 55.2% of non-adherers versus 23.0% of adherers (p=0.002). The PFS and OS in adherers were significantly higher versus non-adherers (p=0.020 and p=0.039). MMAS-8 score was an independent risk factor for PFS (p=0.010) and OS (p=0.031). Among non-adherers, the median OS was only 23.1% (4.2-42%) in patients aged≤10-years-old versus 54.4% (38.8-70%) in adolescents. Most of the patients who experienced TKIs non-adherence suffered pancytopenia.TKIs adherence during treatment significantly influenced the survival of pediatric Ph+ ALL patients, and non-adherers with age≤10-years-old were more vulnerable to TKIs disruption. The cumulative TKIs dose should be especially emphasized to patients with age≤10-years-old, which may result in an inferior achievement of relevant treatment milestones.