The prognosis for patients with relapsed/refractory or measurable (minimal) residual disease-positive Philadelphia chromosome (Ph)-positive acute lymphoblastic leukaemia (ALL) is poor. Currently, ponatinib is the only approved tyrosine kinase inhibitor (TKI) that is effective for Ph-positive ALL with the T315I mutation. Although the report by Liu et al. is a retrospective observational study, it offers prospects for the efficacy of chemotherapy combined with the novel third-generation TKI, olverembatinib, in these conditions, which may be validated in future prospective clinical trials. Commentary on: Liu et al. Efficacy and safety of olverembatinib in adult BCR::ABL1-positive ALL with T315I mutation or relapsed/refractory disease. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19804.