{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:33:44Z","timestamp":1791614024435,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Acute myeloid leukemia (AML) with t(8;21) is traditionally classified as favorable\u2010risk; however, relapse occurs in 30%\u201350% of patients, indicating underlying heterogeneity. The prognostic impact and potential synergy of additional cytogenetic abnormalities (ACAs)\u2014specifically complex karyotype (CK)\u2014and\n KIT<\/jats:italic>\n mutations remain poorly defined.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The authors conducted a retrospective cohort study of 243 adults with t(8;21) AML. CK was defined as the presence of two or more ACAs beyond t(8;21). Prognostic factors were evaluated using multivariable Cox proportional hazards models. An integrated risk stratification was developed based on CK and\n KIT<\/jats:italic>\n mutation status. Minimal residual disease (MRD) was quantified via reverse transcriptase\u2013polymerase chain reaction for the\n RUNX1<\/jats:italic>\n ::\n RUNX1T1<\/jats:italic>\n transcript.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n CK was an independent predictor of inferior overall survival (OS), whereas\n KIT<\/jats:italic>\n mutation predicted inferior disease\u2010free survival (DFS) and event\u2010free survival (EFS) (all\n p<\/jats:italic>\n \u00a0<\u00a0.05). Based on this integrated stratification, patients were categorized into three groups: low\u2010risk (CK\u2013\/\n KIT<\/jats:italic>\n \u2013,\n n<\/jats:italic>\n \u00a0=\u00a0128), intermediate\u2010risk (CK+\u00a0or\n KIT<\/jats:italic>\n +,\n n<\/jats:italic>\n \u00a0=\u00a0100), and high\u2010risk (CK+\/\n KIT<\/jats:italic>\n +,\n n<\/jats:italic>\n \u00a0=\u00a015). The 5\u2010year OS rates were 72.8%, 58.3%, and 41.6%, respectively (\n p<\/jats:italic>\n \u00a0<\u00a0.001). MRD positivity at the time of complete remission (CR) was associated with inferior relapse\u2010free survival (RFS;\n p<\/jats:italic>\n \u00a0=\u00a0.025) and showed a trend toward independent prognostic value (\n p<\/jats:italic>\n \u00a0=\u00a0.068). Biologically, high\u2010risk cases exhibited prominent\n KIT<\/jats:italic>\n driver mutations and enrichment for stem cell maintenance pathways.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CK and\n KIT<\/jats:italic>\n mutations jointly identify a high\u2010risk subgroup within t(8;21) AML. This baseline genetic stratification provides a foundation for risk\u2010adapted therapy, with MRD assessment at CR offering complementary prognostic information.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cncr.70370","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:11:02Z","timestamp":1774368662000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined prognostic impact of complex karyotype and\n KIT<\/i>\n mutations refines risk stratification in t(8;21) acute myeloid leukemia"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6824-8320","authenticated-orcid":false,"given":"Lin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"},{"name":"Zhejiang Key Laboratory for Precision Diagnosis and Treatment of Hematological 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