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This study aimed to investigate whether a paediatric\u2010inspired chemotherapy regimen can reduce CNS relapse in adult ALL compared to the adult regimen. A total of 1005 newly diagnosed adult patients with ALL were enrolled in this study, including 596 patients who received the Hyper\u2010CVAD (cyclophosphamide, vincristine, doxorubicin[adriamycin], and dexamethason) adult regimen and 409 patients who treated with the Precision Classification\u2010Directed Target Total Therapy\u2010ALL\u20102016 (PDT\u2010ALL\u20102016) paediatric\u2010inspired chemotherapy regimen. 11.24% of patients treated with the adult regimen (67\/596) experienced a CNS recurrence, whereas only 7.09% of patients (29\/409) had CNS relapse under the paediatric\u2010inspired chemotherapy regimen. The 5\u2010year cumulative incidence of relapse in the CNS for the paediatric cohort and adult cohort was 7.09% and 11.24% respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.025). Even for patients in the high\u2010risk group, the 5\u2010year cumulative incidence of CNS relapse was significantly lower in the paediatric cohort compared with the adult cohort (6.75% vs. 13.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). The univariate analysis revealed that the paediatric\u2010inspired regimen is a protective factor for reducing CNS relapse (OR\u2009=\u20090.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.029). Collectively, our data suggest that paediatric\u2010inspired chemotherapy may reduce the risk of CNS relapse in adult ALL compared to adult regimens.<\/jats:p>","DOI":"10.1111\/bjh.70067","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:27:27Z","timestamp":1756283247000},"page":"1445-1453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Paediatric\u2010inspired regimen reduces central nervous system relapse in adult acute lymphoblastic leukaemia"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0149-3183","authenticated-orcid":false,"given":"Haimei","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Hematology Nanfang Hospital, Southern Medical University  Guangzhou China"},{"name":"Clinical Medical Research Center of Hematology Diseases of Guangdong Province  Guangzhou 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