{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:12:28Z","timestamp":1755216748793,"version":"3.43.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Mexican and Hispanic children in Mexico and the United States, respectively, have the highest incidence and worst outcomes of pre-B acute lymphoblastic leukemia (ALL) compared with other racial\/ethnic groups. Terminal deoxynucleotidyl transferase (TdT) is an intranuclear DNA polymerase normally present on immature lymphocytes (TdT-positive) and distinguishes ALL from mature lymphoid malignancies. We performed a multisite retrospective study to determine the incidence of TdT-negative precursor B-cell acute lymphoblastic leukemia (pre-B ALL) among Mexican, Caucasian, and US-born Hispanic children to correlate TdT expression with patient characteristics and known prognostic factors. Fisher exact test was performed for categorical variables and the Wilcoxon rank-sum test was used for continuous variables. TdT-negative pre-B ALL was most frequently identified in patients with National Cancer Institute high-risk disease (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.014). TdT-negative expression was also most frequently associated with hypodiploid pre-B ALL (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.001) and KMT2A gene rearrangement (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.0012). Mexican children had the highest incidence of TdT-negative ALL compared with Caucasians and US Hispanics (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001), with an increased incidence of poor prognostic features as well. This study demonstrates significant differences in TdT-negative expression, genomic alterations, and leukemic ploidy based on race and ethnicity.<\/jats:p>","DOI":"10.1097\/mph.0000000000002802","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T09:02:05Z","timestamp":1703235725000},"page":"e131-e136","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico"],"prefix":"10.1097","volume":"46","author":[{"given":"Meagan","family":"Vacek","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology-Oncology, Children\u2019s Mercy Hospital, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura C.","family":"Z\u00e1rraga Vargas","sequence":"additional","affiliation":[{"name":"Stem Cell Biology Lab, Autonomous University of Morelos State, Cuernavaca"},{"name":"The Dr. Ruy Perez Tamayo Diagnostic and Molecular Medicine Unit, Hospital del Ni\u00f1o Morelense, Emiliano Zapata"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Gonz\u00e1lez Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology-Oncology, Children\u2019s Mercy Hospital, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilia","family":"Garcia Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology-Oncology, Children\u2019s Mercy Hospital, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar A.","family":"Tello Teran","sequence":"additional","affiliation":[{"name":"Hematology Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Mojica Cardoso","sequence":"additional","affiliation":[{"name":"Pathology, Hospital del Ni\u00f1o Morelense, Emiliano Zapata"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa V.","family":"Ocampo Roosens","sequence":"additional","affiliation":[{"name":"Pathology, Hospital del Ni\u00f1o Morelense, Emiliano Zapata"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan J.","family":"Acevedo Fernandez","sequence":"additional","affiliation":[{"name":"Autonomous University of Morelos State, Avenida Universidad, Cuernavaca, Morelos, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weijie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Health Services and Outcomes Research, Children\u2019s Mercy Hospital, Kansas City, 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