{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:08:14Z","timestamp":1790759294240,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370181"],"award-info":[{"award-number":["82370181"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Bone marrow fibrosis (MF) reflects stromal remodeling and has been associated with treatment resistance and adverse outcomes in hematologic malignancies; however, its clinical significance in acute lymphoblastic leukemia (ALL) remains uncertain. We retrospectively analyzed 103 patients with newly diagnosed ALL and documented MF grades between 2018 and 2023, comparing patients with MF grades 0\u20131 and those with MF grades 2\u20133. Higher\u2010grade MF was present in 50 patients (48.5%). B\u2010ALL accounted for a greater proportion of cases in the MF 2\u20133 group than in the MF 0\u20131 group (94.0% vs. 69.8%; nominal\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), and this difference remained statistically significant after false discovery rate correction. No mutation\u2010level difference between the MF groups remained significant after correction for multiple comparisons. In Cox regression, MF 2\u20133 was associated with a lower observed hazard of death compared with MF 0\u20131 (adjusted HR, 0.26; 95% CI, 0.12\u20130.55;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). A similar association was observed in a sensitivity analysis restricted to patients with B\u2010ALL (adjusted HR, 0.30; 95% CI, 0.13\u20130.70;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). Given the retrospective design, limited number of deaths, and potential residual confounding, this unexpected inverse association should be considered exploratory and should not be interpreted as evidence of a biologically protective effect of MF. In conclusion, higher\u2010grade MF was common in newly diagnosed ALL and was associated with B\u2010lineage disease. An unexpected inverse association between MF grade and observed mortality was identified in this cohort and persisted in the B\u2010ALL\u2010restricted sensitivity analysis. External validation is required before MF can be considered for prognostic stratification or treatment decision\u2010making.\n                  <\/jats:p>","DOI":"10.1002\/cam4.72339","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:44:21Z","timestamp":1790757861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological Features and Exploratory Outcome Associations of Bone Marrow Fibrosis in Newly Diagnosed Acute Lymphoblastic Leukemia: A Single\u2010Center Retrospective Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Ying","family":"Chen","sequence":"first","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si\u2010Heng","family":"Liu","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cen\u2010Xia","family":"Ran","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu\u2010Chen","family":"Yang","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian\u2010Gui","family":"Peng","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Gao","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9188-9236","authenticated-orcid":false,"given":"Li","family":"Gao","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Mei","family":"Feng","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wen","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Rao","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Yan","family":"Kong","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1752-0511","authenticated-orcid":false,"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical Center of Hematology Xinqiao Hospital of Army Medical University  Chongqing China"},{"name":"Key Laboratory of Hematology and Microenvironment  Chongqing China"},{"name":"State Key Laboratory of Trauma and Chemical Poisoning Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(24)00285\u20100"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010024\u201001626\u20106"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27031"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010024\u201002157\u20102"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010024\u201001571\u20104"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408\u2010024\u201001031\u20109"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010022\u201001718\u20107"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010024\u201001630\u2010w"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2023.12.015"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1212392"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2405072"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.294"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021004580"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010024\u201002395\u20104"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010025\u201002599\u20102"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00826"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27098"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72339","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.72339","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:44:22Z","timestamp":1790757862000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.72339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/cam4.72339"],"URL":"https:\/\/doi.org\/10.1002\/cam4.72339","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72339"}}