{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:12:30Z","timestamp":1788581550105,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82570191"],"award-info":[{"award-number":["82570191"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Essential thrombocythaemia (ET) in adolescents and young adults (AYA, 15\u201339\u2009years) is a distinct entity with an incompletely defined prognosis. In this multicentre retrospective study, 1728 ET patients from 29 centres across China were stratified into AYA (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009328) and non\u2010AYA (\u226540\u2009years,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091400) cohorts. We compared their clinical profiles, genomic landscapes, long\u2010term outcomes and risk factors for progression to post\u2010ET myelofibrosis (MF). AYA patients had fewer cardiovascular risks and lower thrombosis rates, but higher rates of extreme thrombocytosis. Molecularly, AYA patients were enriched for\n                    <jats:italic>calreticulin<\/jats:italic>\n                    (\n                    <jats:italic>CALR<\/jats:italic>\n                    ) mutations, whereas\n                    <jats:italic>Janus kinase 2<\/jats:italic>\n                    (\n                    <jats:italic>JAK2<\/jats:italic>\n                    ) predominated in older patients. The burden of non\u2010driver mutations (\n                    <jats:italic>tet methylcytosine dioxygenase 2<\/jats:italic>\n                    [\n                    <jats:italic>TET2<\/jats:italic>\n                    ],\n                    <jats:italic>DNA methyltransferase 3A<\/jats:italic>\n                    [\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    ],\n                    <jats:italic>ASXL transcriptional regulator 1<\/jats:italic>\n                    [\n                    <jats:italic>ASXL1<\/jats:italic>\n                    ],\n                    <jats:italic>SH2\u2011B adaptor protein 3<\/jats:italic>\n                    [\n                    <jats:italic>SH2B3<\/jats:italic>\n                    ]) was lower in AYA patients. Consequently, AYA patients achieved superior long\u2010term outcomes across all key survival endpoints, including overall, myelofibrosis\u2010free and leukaemia\u2010free survival. Analysis of post\u2010ET MF progression risks identified age\u2010specific patterns:\n                    <jats:italic>CALR<\/jats:italic>\n                    mutations are enriched in younger patients and show an age\u2010specific association with MF progression. AYA\u2010ET constitutes a unique clinicomolecular subtype with a favourable prognosis, supporting age\u2010stratified management. The enrichment of\n                    <jats:italic>CALR<\/jats:italic>\n                    mutations and their specific link to MF progression in young patients underscore the urgent need for targeted therapies against\n                    <jats:italic>CALR<\/jats:italic>\n                    \u2010mutant clones.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70818","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:26:23Z","timestamp":1788578783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age as a core disease modifier: Distinct clinical, molecular and prognostic landscapes of essential thrombocythaemia in adolescents and young adults"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0485-1124","authenticated-orcid":false,"given":"Jia","family":"Li","sequence":"first","affiliation":[{"name":"Department of Haematology, The First Affiliated 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9038-6813","authenticated-orcid":false,"given":"Binbin","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Haematology The First Affiliated Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Haematology The First Affiliated Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7329-3608","authenticated-orcid":false,"given":"Xiaojing","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou Zhejiang 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Second Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Haematology, Huzhou Central Hospital Affiliated Central Hospital of Huzhou University  Huzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huyi","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Haematology The Affiliated Hospital of ShaoXing University (ShaoXing Municipal Hospital)  Shaoxing Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinli","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Haematology Pinghu First People's Hospital  Pinghu Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Haematology The Fifth Affiliated 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