{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:21:21Z","timestamp":1782958881987,"version":"3.54.5"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-1-003"],"award-info":[{"award-number":["2021-I2M-1-003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of central nervous system (CNS) leukemia is approximately 5%-10% in pediatric T-cell acute lymphoblastic leukemia (T-ALL), typically conferring a poor prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We further investigated the relationship between prognosis and CNS status at different treatment stages, retrospectively examining 185 patients with pediatric T-ALL of 2131 consecutive patients with ALL seen between April 2008 and October 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with CNS involvement-positive (CNSI+) disease during induction had lower initial platelet counts (P\u2009=\u2009.021), a higher proportion of ETP-ALL (P\u2009=\u2009.031), hepatomegaly (P\u2009=\u2009.034), and splenomegaly (P\u2009=\u2009.030), but a lower recurrence rate (P\u2009=\u2009.004) than those of patients with CNSI+ disease occurring in the consolidation\/maintenance stages. Children with CNSI+ disease in the consolidation\/maintenance stages by univariate\/multivariate analyses had a significantly lower 10-year overall survival (OS) (46.2\u2009\u00b1\u200910.8%, 67.5\u2009\u00b1\u20099.5%, and 80.7\u2009\u00b1\u20093.4%, P\u2009=\u2009.003), event-free survival (EFS; 20.8\u2009\u00b1\u20098.3%, 48.0\u2009\u00b1\u200910.0%, and 77.4\u2009\u00b1\u20093.6%, P\u2009&amp;lt;\u2009.001), and a significantly higher cumulative recurrence rate (CRR) (76.8\u2009\u00b1\u20099.1%, 48.6\u2009\u00b1\u200910.1%, and 17.3\u2009\u00b1\u20093.3%, P\u2009&amp;lt;\u2009.001) than those of patients with CNSI+ disease in induction and those who were CNSI\u2212 (P values all &amp;lt;.05). PHF6, RELN, TP53, and IKZF1 mutations were more common in patients with CNSI+ observed during the consolidation\/maintenance stages (P values all &amp;lt;.05), which may indicate a role in pathogenesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CNSI+ disease, especially in the consolidation\/maintenance stage, was an independent poor prognostic factor in pediatric T-ALL. HSCT partially improved outcomes of children with T-ALL. Individualized treatment strategies containing a combination of immunotherapy and targeted therapy in addition to chemotherapy may improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf383","type":"journal-article","created":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T12:56:37Z","timestamp":1763297797000},"source":"Crossref","is-referenced-by-count":1,"title":["Central nervous system involvement-positive disease in consolidation\/maintenance stage is a poor prognostic factor in pediatric T-cell acute lymphoblastic leukemia: a Chinese single-center report"],"prefix":"10.1093","volume":"30","author":[{"given":"Xiaoming","family":"Liu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zou","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumei","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofan","family":"Zhu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 301600,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4882-2607","authenticated-orcid":false,"given":"Wenyu","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020,","place":["China"]},{"name":"Tianjin Institutes of Health Science , Tianjin 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