{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:08:50Z","timestamp":1791950930985,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006058","name":"St. Baldrick's Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute myeloid leukemia (AML) with megakaryocytic differentiation (AMkL) is a rare subtype of AML more common in children. Recent literature has identified multiple fusions associated with this type of leukemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Morphology, cytogenetics, and genomic sequencing were assessed in patients from Children's Oncology Group trials AAML0531 and AAML1031 with central\u2010pathology review confirmed non\u2010Down syndrome AMkL. The 5\u2010year event\u2010free survival (EFS), overall survival (OS), and RR were evaluated in these AMkL subcategories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 107 cases of AMkL (5.5%) were included. Distinct fusions were identified in the majority: <jats:italic>RBM15::MRTFA<\/jats:italic> (20%), <jats:italic>CBFA2T3::GLIS2<\/jats:italic> (16%), <jats:italic>NUP98<\/jats:italic> (10%), <jats:italic>KMT2A<\/jats:italic> (7%), <jats:italic>TEC::MLLT10<\/jats:italic> (2%), <jats:italic>MECOM<\/jats:italic> (1%), and <jats:italic>FUS::ERG<\/jats:italic> (1%); many of the remaining cases were classified as AMkL with (other) myelodysplasia\u2010related changes (MRC). Very few cases had AML\u2010associated somatic mutations. Cases with <jats:italic>CBFA2T3::GLIS2<\/jats:italic> were enriched in trisomy 3 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.015) and the RAM phenotype, with associated high CD56 expression (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Cases with <jats:italic>NUP98<\/jats:italic> fusions were enriched in trisomy 6 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), monosomy 13\/del(13q) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), trisomy 21 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.026), and\/or complex karyotypes (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.026). While different 5\u2010year EFS and OS were observed in AMkL in each trial, in general, those with <jats:italic>CBFA2T3::GLIS2<\/jats:italic> or <jats:italic>KMT2A<\/jats:italic> rearrangements had worse outcomes compared to other AMkL, while those with <jats:italic>RBM15::MRTFA<\/jats:italic> or classified as AMkl\u2010MRC fared better. AMkL with <jats:italic>NUP98<\/jats:italic> fusions also had poor outcomes in the AAML1031 trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Given the differences in outcomes, AMkL classification by fusions, cytogenetics, and morphology may be warranted to help in risk stratification and therapeutic options.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30251","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T03:49:11Z","timestamp":1676432951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Pathologic, cytogenetic, and molecular features of acute myeloid leukemia with megakaryocytic differentiation: A report from the Children's Oncology Group"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1898-1252","authenticated-orcid":false,"given":"Karen 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