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The classification of T\u2010ALL primarily hinges on immunophenotype, encompassing early T\u2010cell precursor (ETP)\u2010ALL, near\u2010ETP\u2010ALL, and non\u2010ETP\u2010ALL. We summarized clinical information from 117 patients, with genetic data available for 77 patients and transcriptomic data available for 24 patients. An ETP\u2010like score model was established based on transcriptome, aiming to address the subjectivity in the current T\u2010ALL immunophenotype classification. The retrospective analysis indicated that ETP immunophenotype was not a prognostic factor for T\u2010ALL patients. Compared to non\u2010ETP\u2010ALL patients, ETP\u2010like patients including ETP\u2010ALL and near\u2010ETP\u2010ALL were more likely to carry <jats:italic>MED12<\/jats:italic> gene mutations, which may predict a dismal outcome. Transcriptomic analysis suggested that T\u2010ALL patients with different immunophenotypes were in accordance with the T\u2010cell development trajectory, while ETP\u2010like patients exhibited characteristics of early T\u2010cell development. Finally, we established an ETP\u2010like score model and confirmed its efficiency across four independent\u00a0cohorts, with sensitivity exceeding 80%. And T\u2010ALL patients with high ETP\u2010like score were associated with poor prognosis. In conclusion, our study elucidated the clinical and molecular features of distinct subtypes of T\u2010ALL patients, providing new valuable insights for T\u2010ALL classification.<\/jats:p>","DOI":"10.1111\/cas.70010","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:04:12Z","timestamp":1739250252000},"page":"1126-1138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Clinical and Molecular Characterization of Distinct Subtypes in Adult T Cell Acute Lymphoblastic Leukemia"],"prefix":"10.1111","volume":"116","author":[{"given":"Heye","family":"Yu","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 and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Tianjin 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