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In this retrospective study of 345 consecutive pediatric patients with\n                    <jats:italic>ETV6<\/jats:italic>\n                    ::\n                    <jats:italic>RUNX1<\/jats:italic>\n                    -positive ALL treated in accordance with the protocol of the Chinese Children\u2019s Leukemia Group (CCLG-ALL 2008), CD33 expression (CD33\n                    <jats:sup>+<\/jats:sup>\n                    ) on leukemic blasts was detected in 55.9% of patients and was significantly associated with minimal residual disease (MRD) positivity on day 15 (D15-MRD-positive) (65.2% vs. 42.0%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Multivariate analysis revealed CD33\n                    <jats:sup>+<\/jats:sup>\n                    status as an independent risk factor for D15-MRD positivity (odds ratio (OR)\u2009=\u20092.66, 95% confidence interval (CI) 1.66\u20134.26). Among CD33\n                    <jats:sup>+<\/jats:sup>\n                    patients, those who were D15-MRD-positive had significantly inferior 5-year and 10-year event-free survival (EFS) relative to those who were D15-MRD-negative (5-year EFS: 91.9% \u00b1 2.4% vs. 100%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.027; 10-year EFS: 89.2% \u00b1 3.0% vs. 100%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.014). This prognostic association was not observed in CD33-negative patients. In conclusion, the combination of CD33\n                    <jats:sup>+<\/jats:sup>\n                    and D15-MRD-positivity may identify a distinct high-risk subgroup within\n                    <jats:italic>ETV6<\/jats:italic>\n                    ::\n                    <jats:italic>RUNX1<\/jats:italic>\n                    -positive ALL. Early intervention, potentially including CD33-directed therapy, may represent a promising strategy to improve outcomes in this subgroup, although further validation is warranted.\n                  <\/jats:p>","DOI":"10.1007\/s00277-026-07089-8","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T03:14:43Z","timestamp":1780024483000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CD33 expression combined with D15-MRD positivity identifies poor prognosis in children with ETV6::RUNX1-positive ALL"],"prefix":"10.1007","volume":"105","author":[{"given":"Xueling","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruidong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengli","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaole","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijing","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxia","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huyong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"7089_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1007\/978-981-10-3233-2_13","volume":"962","author":"A Sundaresh","year":"2017","unstructured":"Sundaresh A, Williams O (2017) Mechanism of ETV6-RUNX1 Leukemia. 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