{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T15:14:00Z","timestamp":1778253240828,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early T\u2010cell precursor acute lymphoblastic leukemia (ETP\u2010ALL) is a distinct subtype of T\u2010ALL defined by an immature immunophenotype and unique molecular features. It is often associated with chemoresistance and poor outcomes. Accurate recognition is crucial for therapy optimization and consideration of hematopoietic stem cell transplantation. This study evaluated the Tokyo Children's Cancer Study Group (TCCSG) six\u2010marker flow cytometric scoring system in identifying ETP\u2010ALL and assessed its clinicopathological features and treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive T\u2010ALL cases diagnosed between 2019 and 2023 were retrospectively analyzed. Clinical, immunophenotypic, and treatment\u2010related data were compared between ETP\u2010ALL and non\u2010ETP\u2010ALL subgroups. The TCCSG six\u2010marker scoring system (CD34, HLA\u2010DR, CD8, CD5, CD13, CD33) was applied, and receiver operating characteristic curve analysis determined the optimal cutoff for diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 104 T\u2010ALL cases, 25 (24.1%) were classified as ETP\u2010ALL. ETP\u2010ALL was more common in adults (&gt;\u200918\u2009years; 72.0% vs. 48.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Compared with non\u2010ETP\u2010ALL, patients showed lower leukocyte counts (&lt;\u2009100\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L), fewer peripheral blasts, and higher platelet counts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). At end\u2010of\u2010induction (EOI), complete remission rates were lower in ETP\u2010ALL (73.3% vs. 96.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), though no significant differences were observed in EOI measurable residual disease, consolidation response, or survival between the groups. A cutoff score \u2265\u20093 using the TCCSG system yielded 88% sensitivity and 94.9% specificity (AUC\u2009=\u20090.986;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ETP\u2010ALL represents a biologically distinct T\u2010ALL subtype with inferior early treatment responses. The TCCSG six\u2010marker scoring system is reliable, accurate, and practical for routine diagnosis, particularly in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70065","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T23:16:02Z","timestamp":1770419762000},"page":"607-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological and Immunophenotypic Analysis of Early T\u2010Cell Precursor Acute Lymphoblastic Leukemia With Application of the Tokyo Children's Cancer Study Group Flow Cytometry Scoring System"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9370-5063","authenticated-orcid":false,"given":"Soundarya","family":"Ravi","sequence":"first","affiliation":[{"name":"Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narasimhapriyan","family":"Kannan","sequence":"additional","affiliation":[{"name":"Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8247-3343","authenticated-orcid":false,"given":"Prabhu","family":"Manivannan","sequence":"additional","affiliation":[{"name":"Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-1512","authenticated-orcid":false,"given":"Rakhee","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smita","family":"Kayal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)  Puducherry India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2016.1.580"},{"key":"e_1_2_12_3_1","first-page":"1783","article-title":"Proposals for the Immunological Classification of Acute Leukemias. 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