{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:10:00Z","timestamp":1790244600090,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions in pediatric anaplastic lymphoma kinase (ALK)\u2010positive anaplastic large\u2010cell lymphoma (ALK+ ALCL) are rare and insufficiently characterized in Chinese populations. This study analyzed the clinical features, treatment responses, and potential prognostic implications of these variants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective study, eight pediatric patients with ALK+ ALCL and non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions were diagnosed between April 2017 and April 2025. For prognostic comparison, a cohort of 107 newly diagnosed patients with\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions was used. Clinical data, treatment courses, and outcomes were reviewed. Event\u2010free survival (EFS) was estimated using the Kaplan\u2013Meier method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 128 ALK+ ALCL patients, 8 (6.3%) had non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions (\n                      <jats:italic>TPM3<\/jats:italic>\n                      ,\n                      <jats:italic>n<\/jats:italic>\n                      = 3;\n                      <jats:italic>ATIC<\/jats:italic>\n                      ,\n                      <jats:italic>n<\/jats:italic>\n                      = 2;\n                      <jats:italic>CLTC<\/jats:italic>\n                      ,\n                      <jats:italic>MYH9<\/jats:italic>\n                      ,\n                      <jats:italic>TRAF1<\/jats:italic>\n                      ,\n                      <jats:italic>n<\/jats:italic>\n                      = 1 each). At a median follow\u2010up of 17.5 months (range, 1.2\u201397.9), all patients were alive. Analysis of patients with non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions (\n                      <jats:italic>n<\/jats:italic>\n                      = 7, newly diagnosed) indicated a trend toward inferior 5\u2010year EFS compared with the\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      group. Within the non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      cohort, no events were observed in the three patients\n                      <jats:italic>TPM3\u2010ALK<\/jats:italic>\n                      fusions, while four patients with other fusion types experienced relapse or disease progression. ALK inhibitors (crizotinib\/alectinib) were associated with sustained remission in three patients with relapsed\/refractory disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Pediatric ALK+ ALCL with non\u2010\n                      <jats:italic>NPM1\u2010ALK<\/jats:italic>\n                      fusions exhibits diverse clinical features and outcomes.\n                      <jats:italic>TPM3\u2010ALK<\/jats:italic>\n                      fusions might correlate with a more favorable course, while other variants may face a potentially higher relapse risk. ALK inhibitors showed promising efficacy in the salvage setting. These preliminary findings highlight the need for larger prospective studies to validate mutation\u2010specific risk stratification and therapeutic strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70045","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T06:55:38Z","timestamp":1766472938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Characteristics and Prognostic Analysis of Non\u2010\n                    <i>NPM1\u2010ALK<\/i>\n                    Fusions in Pediatric Patients With ALK\u2010Positive Anaplastic Large\u2010Cell Lymphoma: A Single\u2010Center Retrospective Study in China"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6505-8630","authenticated-orcid":false,"given":"Ting","family":"Zhu","sequence":"first","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Ju","family":"Zhou","sequence":"additional","affiliation":[{"name":"Pathology Department Beijing Children's Hospital Capital Medical University National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Jin","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Huang","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5334-9706","authenticated-orcid":false,"given":"Zhi\u2010Gang","family":"Li","sequence":"additional","affiliation":[{"name":"Hematologic Diseases Laboratory Beijing Pediatric Research Institute Beijing Children's Hospital Capital Medical University National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian\u2010You","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"},{"name":"Hematologic Diseases Laboratory Beijing Pediatric Research Institute Beijing Children's Hospital Capital Medical University National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1455-4253","authenticated-orcid":false,"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2048-6397","authenticated-orcid":false,"given":"Yan\u2010Long","family":"Duan","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Pediatric Oncology Center Beijing Children's Hospital Beijing Key Laboratory of Pediatric Hematology Oncology Key Laboratory of Major Disease in Children Capital Medical University National Center for Children's Health Ministry of Education  Beijing 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