{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:04:09Z","timestamp":1790888649674,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T00:00:00Z","timestamp":1575504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Adult T\u2010cell acute lymphoblastic leukemia (T\u2010ALL) is a heterogeneous group of acute leukemias that account for about one third of all cases of Philadelphia chromosome (Ph)\u2010negative ALL. Recently, a molecular classifier using the mutational status of <jats:italic>NOTCH1<\/jats:italic>, <jats:italic>FBXW7<\/jats:italic>, <jats:italic>RAS<\/jats:italic>, and <jats:italic>PTEN<\/jats:italic> (NFRP) has been shown to distinguish low\u2010 vs high\u2010risk groups in adult T\u2010ALL patients treated using the Berlin\u2010Frankfurt\u2010M\u00fcnster ALL protocol. However, it is unknown if this molecular classifier can stratify adult T\u2010ALL patients treated with hyper\u2010CVAD\u00a0\u00b1\u00a0nelarabine. We identified a relatively small cohort of 27 adults with T\u2010ALL who were uniformly treated with hyper\u2010CVAD\u00a0\u00b1\u00a0nelarabine with available mutational analysis at time of diagnosis. The most commonly mutated genes in this group were <jats:italic>NOTCH1<\/jats:italic> (52%), <jats:italic>NRAS<\/jats:italic> (22%), <jats:italic>DNMT3A<\/jats:italic> (19%), <jats:italic>KRAS<\/jats:italic> (15%), and <jats:italic>TP53<\/jats:italic> (7%). The NFRP molecular classifier failed to stratify overall survival (OS; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.84) and relapse\u2010free survival (RFS; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.18) in this cohort. We developed a new stratification model combining <jats:italic>K\/NRAS<\/jats:italic> and <jats:italic>TP53<\/jats:italic> mutations as high\u2010risk factors and showed that mutations in these genes predicted poorer OS (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and RFS (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). While the current study is limited by cohort size, these data suggest that the NFRP molecular classifier might not be applicable to adult T\u2010ALL patients treated with hyper\u2010CVAD\u00a0\u00b1\u00a0nelarabine. <jats:italic>RAS\/TP53<\/jats:italic> mutation status, however, was useful in risk stratification in adults with T\u2010ALL.<\/jats:p>","DOI":"10.1002\/cam4.2757","type":"journal-article","created":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T12:48:07Z","timestamp":1575550087000},"page":"849-858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<i>RAS<\/i> and <i>TP53<\/i> can predict survival in adults with T\u2010cell lymphoblastic leukemia treated with hyper\u2010CVAD"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4610-7562","authenticated-orcid":false,"given":"Ali","family":"Sakhdari","sequence":"first","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5140-3633","authenticated-orcid":false,"given":"Beenu","family":"Thakral","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanam","family":"Loghavi","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-5249","authenticated-orcid":false,"given":"Rashmi","family":"Kanagal\u2010Shamanna","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6630-4128","authenticated-orcid":false,"given":"C. Cameron","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Routbort","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajyalakshmi","family":"Luthra","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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