{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:08:49Z","timestamp":1790244529112,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"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":["82102777"],"award-info":[{"award-number":["82102777"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood & Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n \n To investigate the distribution and molecular characteristics of\n MTAP<\/jats:italic>\n rearrangements in pediatric acute lymphoblastic leukemia (ALL) and assess their impact on clinical features, treatment response, and prognosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed 338 pediatric ALL patients. Patients were stratified into two cohorts based on\n MTAP<\/jats:italic>\n rearrangement status: the\n MTAP<\/jats:italic>\n \u2010r group and the non\u2010\n MTAP<\/jats:italic>\n \u2010r group. Baseline clinical characteristics, molecular profiles, and induction therapy responses were compared between the groups. Prognostic outcomes were also evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 338 pediatric ALL patients, 32 (9.47%) harbored\n MTAP<\/jats:italic>\n rearrangements. Compared to the non\n \u2010MTAP<\/jats:italic>\n \u2010r group, patients in the\n MTAP<\/jats:italic>\n \u2010r group demonstrated a significantly higher proportion of T\u2010ALL (\n p\u00a0<\/jats:italic>\n <\u00a00.05), elevated peripheral WBC counts at diagnosis, higher LDH levels, and were more frequently classified into intermediate\u2010\/high\u2010risk groups (\n p\u00a0<\/jats:italic>\n <\u00a00.05). Five distinct\n MTAP<\/jats:italic>\n rearrangement patterns were identified, with\n MTAP::CDKN2B\u2010AS1<\/jats:italic>\n being the most prevalent (75.0%). Regarding mutational profiles,\n MTAP<\/jats:italic>\n \u2010r patients exhibited a higher frequency of mutations in\n NOTCH1<\/jats:italic>\n ,\n PTEN<\/jats:italic>\n ,\n FBXW7<\/jats:italic>\n ,\n SRCAP<\/jats:italic>\n , and\n USP7<\/jats:italic>\n . Furthermore, the mutated genes were significantly enriched in pathways related to viral carcinogenesis, immune evasion, and metabolic signaling. Patients with\n MTAP<\/jats:italic>\n \u2010r ALL exhibited significantly inferior outcomes compared to those in the non\u2010\n MTAP<\/jats:italic>\n \u2010r group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n MTAP<\/jats:italic>\n rearrangement defines a distinct and clinically adverse subset of pediatric ALL characterized by specific fusion architecture and an unfavorable co\u2010mutation pattern. Beyond its diagnostic value,\n MTAP<\/jats:italic>\n \u2010r represents a promising biomarker for trial enrollment and future risk\u2010adapted strategies. Confirmation of independent prognostic impact and therapeutic utility will require multivariable analyses and prospective, biomarker\u2010driven studies.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mpo.70012","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T07:56:56Z","timestamp":1763625416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Impact of\n MTAP<\/i>\n Rearrangement in Pediatric Acute Lymphoblastic Leukemia: Insights From Whole Transcriptome Analysis"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6310-6155","authenticated-orcid":false,"given":"Sidong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatrics The First Affiliated Hospital of Zhengzhou University Zhengzhou China"},{"name":"Department of Pediatrics State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The First Affiliated Hospital of Zhengzhou University Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The First Affiliated Hospital of Zhengzhou University Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The First Affiliated Hospital of Zhengzhou University Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3067-5039","authenticated-orcid":false,"given":"Yadong","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The First Affiliated Hospital of Zhengzhou University Zhengzhou 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