目的：总结费城染色体样急性淋巴细胞白血病（Ph-like ALL）常见基因患儿的临床数据和预后。方法：这是一项回顾性队列研究。收集了2017年1月至2022年1月在郑州大学第一附属医院、河南省儿童医院、河南省肿瘤医院和河南省人民医院治疗的56名Ph-like ALL常见基因病例的临床数据（Ph-like ALL阳性组），同时选择了69名相同年龄的其他高危B细胞急性淋巴细胞白血病（B-ALL）患儿作为阴性组。回顾性分析了两组的临床特征和预后。使用Mann-Whitney U检验和χ2检验进行组间比较。采用Kaplan-Meier方法绘制生存曲线，采用Log-Rank检验进行单因素分析，采用Cox回归模型进行多因素预后分析。结果：在56名Ph-like ALL阳性患者中，有30名男性和26名女性，15例年龄超过10岁。Ph-like ALL阴性组有69名患者。与阴性组相比，阳性组中的儿童年龄更大（6.4（4.2，11.2）岁vs.4.7（2.8，8.4）岁），高白细胞症（≥50×109/L）更常见（25%（14/56）vs.9%（6/69）），差异具有统计学意义（P <0.05）。在Ph-like ALL阳性组中，32例为IK6阳性（1例与IK6和EBF1-PDGFRB共表达），24例为IK6阴性，其中9例为CRLF2阳性（包括2例P2RY8-CRLF2和7例CRLF2高表达），5例为PDGFRB重排，4例为ABL1重排，4例为JAK2重排，1例为ABL2重排，1例为EPOR重排。Ph-like ALL阳性组的随访时间为22（12，40）个月，阴性组为32（20，45）个月。阳性组的3年总生存率（OS）显著低于阴性组（（72±7）%vs.（86±5）%，χ2=4.59，P <0.05）。与24名IK6阴性患者相比，32名IK6阳性患者的3年无事件生存率（EFS）高，差异具有统计学意义（（88±9）%vs.（65±14）%，χ2=5.37，P <0.05）。多元Cox回归分析显示，骨髓最小残留病（MRD）在第一次诱导结束时未转阴（HR=4.12，95％CI 1.13～15.03），是Ph-like ALL常见基因患儿的独立预后风险因素。结论：患有Ph-like ALL普通基因的儿童诊断时年龄较大，白细胞计数高，生存率较低。骨髓MRD在第一次诱导结束时未转阴是Ph-like ALL常见基因患儿的独立预后风险因素。

Objective: To summarize the clinical data and prognosis of children with Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) common genes. Methods: This was a retrospective cohort study.Clinical data of 56 children with Ph-like ALL common gene cases (Ph-like ALL positive group) treated from January 2017 to January 2022 in the First Affiliated Hospital of Zhengzhou University, Henan Children's Hospital, Henan Cancer's Hospital and Henan Provincial People's Hospital were collected, 69 children with other high-risk B cell acute lymphoblastic leukemia (B-ALL) at the same time and the same age were selected as the negative group. The clinical characteristics and prognosis of two groups were analyzed retrospectively. Comparisons between groups were performed using Mann-Whitney U test and χ2 test. Kaplan-Meier method was used for survival curve, Log-Rank test was used for univariate analysis, and the Cox regression model was used for multivariate prognosis analysis. Results: Among 56 Ph-like ALL positive patients, there were 30 males and 26 females, and 15 cases were over 10 years old. There were 69 patients in Ph-like ALL negative group. Compared with the negative group, the children in positive group were older (6.4 (4.2, 11.2) vs. 4.7 (2.8, 8.4) years), and hyperleukocytosis (≥50×109/L) was more common (25% (14/56) vs. 9% (6/69)), the differences were statistically significant (both P<0.05). In the Ph-like ALL positive group, 32 cases were positive for IK6 (1 case was co-expressed with IK6 and EBF1-PDGFRB), 24 cases were IK6-negative, of which 9 cases were CRLF2 positive (including 2 cases with P2RY8-CRLF2, 7 cases with CRLF2 high expression), 5 cases were PDGFRB rearrangement, 4 cases were ABL1 rearrangement, 4 cases were JAK2 rearrangement, 1 case was ABL2 rearrangement and 1 case was EPOR rearrangement. The follow-up time of Ph-like ALL positive group was 22 (12, 40) months, and 32 (20, 45) months for negative group. The 3-year overall survival (OS) rate of positive group was significantly lower than the negative group ((72±7) % vs. (86±5) %, χ2=4.59, P<0.05). Compared with the 24 IK6-negative patients, the 3-year event free survival (EFS) rate of 32 IK6 positive patients was higher, the difference was statistically significant ((88±9) % vs. (65±14) %, χ2=5.37, P<0.05). Multivariate Cox regression analysis showed that the bone marrow minimal residual disease (MRD) not turning negative at the end of first induction (HR=4.12, 95%CI 1.13-15.03) independent prognostic risk factor for patient with Ph-like ALL common genes. Conclusions: Children with Ph-like ALL common genes were older than other high-risk B-ALL patients at diagnosis, with high white blood cells and lower survival rate. The bone marrow MRD not turning negative at the end of first induction were independent prognostic risk factor for children with Ph-like ALL common gene.