{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:25:12Z","timestamp":1786976712031,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The World Health Organization (WHO) 5th Edition and International Consensus Classification (ICC) have continued to delineate more genetically defined acute leukemias. Both recognize genetic aberrations associated with myelodysplastic syndromes\/neoplasms (MDS) as defining MDS\u2010related AML (AML\u2010MR). Mutations in\n                    <jats:italic>RUNX1<\/jats:italic>\n                    are included in this category in the ICC, but not WHO. The current classifications are unclear on how acute leukemias with ambiguous lineage (ALAL), including those of mixed lineage (MPAL) and those without a defined lineage (AUL), should be categorized in the presence of such mutations. Our multi\u2010institutional study aims to determine the significance of\n                    <jats:italic>RUNX1<\/jats:italic>\n                    mutation in ALAL compared to de novo AML. Newly diagnosed MPAL, AUL, and AML with\n                    <jats:italic>RUNX1<\/jats:italic>\n                    mutations were collected. ALAL with MDS\u2010related cytogenetics,\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    ,\n                    <jats:italic>KMT2A<\/jats:italic>\n                    rearrangements, or\n                    <jats:italic>ZNF384<\/jats:italic>\n                    or\n                    <jats:italic>BCL11b<\/jats:italic>\n                    abnormalities were excluded. We analyzed 17 cases of ALAL and 71 cases of AML that met inclusion criteria. ALAL\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    and AML\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    showed overlapping mutational landscapes with frequent comutations in MDS\u2010associated genes. No ALAL\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    or AML\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    cases showed concomitant\n                    <jats:italic>TP53<\/jats:italic>\n                    mutation. ALAL\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    had more bone marrow blasts and more karyotypic abnormalities; however, neither impacted survival, nor did\n                    <jats:italic>RUNX1<\/jats:italic>\n                    variant allele frequency (VAF). Survival analysis revealed similarly poor outcomes between them. AML\u2010directed therapies and allogeneic hematopoietic stem cell transplant trended toward improved survival in ALAL\u2010\n                    <jats:italic>RUNX1;<\/jats:italic>\n                    however, it did not reach significance. Our results suggest ALAL\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    is associated with younger age, higher blasts, and more karyotypic abnormalities, but has similar clinical and genetic features and outcomes to AML\u2010\n                    <jats:italic>RUNX1<\/jats:italic>\n                    . Our findings suggest, like other MR mutations,\n                    <jats:italic>RUNX1<\/jats:italic>\n                    \u2010mutated ALALs should be included within AML\u2010MR.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70116","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T15:59:14Z","timestamp":1760803154000},"page":"70-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute Leukemias of Ambiguous Lineage With\n                    <i>RUNX1<\/i>\n                    Mutations Show Similar Prognosis Compared to Acute Myeloid Leukemia With\n                    <i>RUNX1<\/i>\n                    Mutations: A Study From the Bone Marrow Pathology Group"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1144-8025","authenticated-orcid":false,"given":"Timothy J.","family":"Kirtek","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5638-4371","authenticated-orcid":false,"given":"Weina","family":"Chen","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaryse C.","family":"Harris","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bagg","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Foucar","sequence":"additional","affiliation":[{"name":"University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Tam","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1660-7013","authenticated-orcid":false,"given":"Attilio","family":"Orazi","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Science Center  El Paso Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Hsi","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Hasserjian","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9385-9911","authenticated-orcid":false,"given":"Sa A.","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8604-2073","authenticated-orcid":false,"given":"David P.","family":"Ng","sequence":"additional","affiliation":[{"name":"ARUP Laboratories  Salt Lake City Utah USA"},{"name":"University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy I.","family":"George","sequence":"additional","affiliation":[{"name":"ARUP Laboratories  Salt Lake City Utah USA"},{"name":"University of Utah  Salt Lake City Utah 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