{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:23:05Z","timestamp":1789017785111,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of the study was to evaluate the incidence and prognostic impact of central nervous system (CNS) involvement in infants with B\u2010cell precursor acute lymphoblastic leukemia (BCP\u2010ALL), as well as its relation with minimal residual disease (MRD) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 139 consecutive infants with BCP\u2010ALL from the MLL\u2010Baby trial were studied. Cerebrospinal fluid (CSF) samples were investigated by microscopy of cytospin slides. MRD was evaluated according to the protocol schedule by flow cytometry and PCR for fusion gene transcripts (FGT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Involvement of the CNS at any level was found in 50 infants (36.0%). The incidence of CNS involvement was higher in patients with <jats:italic>KMT2A<\/jats:italic> gene rearrangements (44.0% for <jats:italic>KMT2A<\/jats:italic>\u2010r vs. 15.4% for <jats:italic>KMT2A<\/jats:italic>\u2010g, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003). The outcome of CNS\u2010positive infants was significantly worse than that of CNS\u2010negative infants, although this prognostic impact was limited to the <jats:italic>KMT2A<\/jats:italic>\u2010r group (event\u2010free survival 0.21 for CNS\u2010positive vs. 0.48 for CNS\u2010negative infants, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.044). CNS\u2010positive infants could not be treated successfully by conventional chemotherapy alone, irrespective of the rapidity of MRD response. In contrast, the combination of initial CNS negativity and FGT\u2010MRD negativity identified a group comprising up to one\u2010third of infants with <jats:italic>KMT2A<\/jats:italic>\u2010r ALL who can be treated with chemotherapy and achieve very good outcomes (disease\u2010free survival above 95%), and remaining patients should be allocated to receive other types of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We can conclude that this combination of initial CNS involvement and MRD data can significantly improve risk\u2010group allocation in future clinical trials enrolling infants with ALL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29860","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T09:53:24Z","timestamp":1655459604000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and prognostic value of central nervous system involvement in infants with B\u2010cell precursor acute lymphoblastic leukemia treated according to the MLL\u2010Baby protocol"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0889-6986","authenticated-orcid":false,"given":"Alexander","family":"Popov","sequence":"first","affiliation":[{"name":"National Research and Clinical Centre for Pediatric Hematology, Oncology and Immunology  Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigory","family":"Tsaur","sequence":"additional","affiliation":[{"name":"Regional Children's Hospital  Ekaterinburg Russian Federation"},{"name":"Ural State Medical University  Ekaterinburg Russian Federation"},{"name":"Research Institute of Medical Cell Technologies  Ekaterinburg Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan","family":"Permikin","sequence":"additional","affiliation":[{"name":"Regional Children's Hospital  Ekaterinburg 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