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While absence of PBB was not independently associated with survival outcomes when compared to those with PBB, patients without PBB had distinct genetic and clinical characteristics. Notably, we identified a novel genotype\u2013phenotype relationship, in that the patients without PBB had a significantly higher incidence of hyperdiploid B\u2010ALL, accounting for almost half of all patients without PBB (46.9% vs. 22.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Further, absence of PBB was associated with decreased rates of leukaemia involvement of the central nervous system (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>","DOI":"10.1111\/bjh.18552","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T05:19:46Z","timestamp":1668057586000},"page":"338-343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Characterisation of children and adolescents with acute lymphoblastic leukaemia who presented without peripheral blood blasts at diagnosis"],"prefix":"10.1111","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-0569","authenticated-orcid":false,"given":"David Spencer","family":"Mangum","sequence":"first","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Division of Hematology\/Oncology, Department of Pediatrics University of Utah and 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