{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:06:17Z","timestamp":1787817977372,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K08310"],"award-info":[{"award-number":["19K08310"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>PICALM::MLLT10<\/jats:italic>\n                      \u2010positive T\u2010ALL is rare and associated with poor prognosis. Lineage switch to AML is exceptionally uncommon, particularly after long\u2010term remission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      We report an adolescent\n                      <jats:italic>PICALM::MLLT10<\/jats:italic>\n                      \u2010positive T\u2010ALL with a cortical thymocyte, non\u2010ETP phenotype. The patient achieved complete remission but relapsed as AML 6 years later. Cytogenetics revealed del(5q), del(17p), and 17q gain. Mutational profiling demonstrated mutations with LOH in\n                      <jats:italic>NF1<\/jats:italic>\n                      and\n                      <jats:italic>EZH2<\/jats:italic>\n                      , a hemizygous\n                      <jats:italic>SMC1A<\/jats:italic>\n                      mutation, and a hemizygous\n                      <jats:italic>PHF6<\/jats:italic>\n                      mutation detected only after subsequent therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case illustrates that therapy\u2010resistant\n                      <jats:italic>PICALM::MLLT10<\/jats:italic>\n                      progenitors can persist during remission and re\u2010emerge as AML through lineage switch. The sequential acquisition of cooperating genetic lesions supports clonal evolution and highlights the need for molecular monitoring and novel therapeutic strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70217","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T03:41:30Z","timestamp":1769139690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clonal Evolution and Lineage Switch from T\u2010Cell Acute Lymphoblastic Leukemia to Acute Myeloid Leukemia in Therapy\u2010Resistant\n                    <i>PICALM::MLLT10<\/i>\n                    Leukemia"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6138-1690","authenticated-orcid":false,"given":"Machiko","family":"Kawamura","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Medicine Saitama Cancer Center  Saitama Japan"},{"name":"Department of Hematology Saitama Cancer Center Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Sadato","sequence":"additional","affiliation":[{"name":"Clinical Research and Trials Center Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Haruta","sequence":"additional","affiliation":[{"name":"Research Institute for Clinical Oncology Saitama Cancer Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuko","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Hematology Saitama Cancer Center Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Harada","sequence":"additional","affiliation":[{"name":"Clinical Research and Trials Center Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Hematology Division Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Doki","sequence":"additional","affiliation":[{"name":"Hematology Division Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumio","family":"Kasai","sequence":"additional","affiliation":[{"name":"RIKEN Cell Bank Cell Engineering Division RIKEN BioResource 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