{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:27:33Z","timestamp":1774459653547,"version":"3.50.1"},"reference-count":31,"publisher":"American Society of Hematology","issue":"12","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Hypodiploid and BCR::ABL1+ B-cell precursor acute lymphoblastic leukemia (BCP-ALL) confers a high risk of disease relapse. We investigated post\u2013hematopoietic stem cell transplantation (HSCT) outcomes within the prospective FORUM trial, comparing outcomes among these genetic subgroups with those of patients without these lesions. The use of pre- and post-HSCT add-on treatments, including tyrosine kinase inhibitors (TKI) and immunotherapies, was also assessed. Multivariate analysis evaluated associations with overall survival (OS), event-free survival (EFS), and cumulative incidence of relapse (CIR). The FORUM trial enrolled 741 patients aged \u22654 years with BCP-ALL who underwent HSCT from HLA-matched donors (2013-2023). The 3-year OS and EFS did not differ significantly between patients with BCR::ABL1 fusion, hypodiploidy, and neither of these 2 genetic lesions. However, patients with hypodiploid BCP-ALL in second complete remission (CR2) showed inferior OS and EFS, driven by higher nonrelapse mortality (NRM), which occurred exclusively in near-diploid cases. No NRM occurred in severe hypodiploid cases conditioned with total body irradiation. Minimal residual disease (MRD) positivity at transplant predicted worse OS, EFS, and CIR in all genetic groups. Patients with hypodiploid BCP-ALL were difficult to salvage after relapse, even with chimeric antigen receptor T-cell therapy. By contrast, BCR::ABL1+ patients had favorable outcomes, even when MRD positive before HSCT. Prophylactic TKI use after HSCT improved EFS and reduced CIR. BCR::ABL1+ patients who received a transplant in CR2 had a 3-year OS of 96%. In conclusion, the standardized FORUM protocol yielded comparable outcomes across genetic subgroups. Posttransplant TKI maintenance improved outcomes in BCR::ABL1+ BCP-ALL. This trial was registered at www.clinicaltrials.gov as #NCT01949129 and at www.clinicaltrialsregister.eu as #EudraCT2012-0032-22.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2025030951","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T17:50:31Z","timestamp":1763574631000},"page":"1365-1379","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of BCP-ALL with hypodiploidy or\n                    <i>BCR<\/i>\n                    ::\n                    <i>ABL1<\/i>\n                    fusion in children undergoing allogeneic HSCT: results from the FORUM study"],"prefix":"10.1182","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5848-4501","authenticated-orcid":false,"given":"Jochen","family":"Buechner","sequence":"first","affiliation":[{"name":"1Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Poetschger","sequence":"additional","affiliation":[{"name":"2St. Anna Children's Cancer Research Institute, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4554-0265","authenticated-orcid":false,"given":"Peter","family":"Bader","sequence":"additional","affiliation":[{"name":"3Division for Stem Cell Transplantation, Immunology, Department of Pediatrics, Goethe University, University Hospital, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akif","family":"Ye\u015filipek","sequence":"additional","affiliation":[{"name":"4Pediatric Stem Cell Transplantation Unit, Antalya Medical Park Hospital, Antalya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5107-5123","authenticated-orcid":false,"given":"Herbert","family":"Pichler","sequence":"additional","affiliation":[{"name":"2St. Anna Children's Cancer Research Institute, Vienna, Austria"},{"name":"5Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Palma","sequence":"additional","affiliation":[{"name":"6Department of Pediatrics\u2013Bone Marrow Transplantation Unit, Faculty of Medicine, Hospital Luis Calvo Mackenna, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7770-2505","authenticated-orcid":false,"given":"Raquel","family":"Staciuk","sequence":"additional","affiliation":[{"name":"7Hospital de Pediatr\u00eda Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina"},{"name":"8Hospital Sor Maria Ludovica, La Plata, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Riha","sequence":"additional","affiliation":[{"name":"9Department of Pediatric Hematology and Oncology, Motol University Hospital, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gergely","family":"Kriv\u00e1n","sequence":"additional","affiliation":[{"name":"10Pediatric Hematology and Stem Cell Transplantation Department, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Ifversen","sequence":"additional","affiliation":[{"name":"11Department of Pediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3261-1186","authenticated-orcid":false,"given":"Tayfun","family":"G\u00fcng\u00f6r","sequence":"additional","affiliation":[{"name":"12Department of Hematology\/Oncology\/Immunology, Gene Therapy, and Stem Cell Transplantation, Eleonore Foundation and Children\u2019s Research Center, University Children\u2019s Hospital, Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evgenios","family":"Goussetis","sequence":"additional","affiliation":[{"name":"13Stem Cell Transplant Unit, Agia Sofia Children's Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Kalwak","sequence":"additional","affiliation":[{"name":"14Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Toporski","sequence":"additional","affiliation":[{"name":"15Department Cell Therapy and Allogeneic Stem Cell Transplant, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Gabriel","sequence":"additional","affiliation":[{"name":"16The Children's Hospital at Westmead, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleen","family":"Renard","sequence":"additional","affiliation":[{"name":"17University Hospital Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-296X","authenticated-orcid":false,"given":"Cristina","family":"Diaz-de-Heredia","sequence":"additional","affiliation":[{"name":"18Department of Pediatric Hematology and Oncology, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Institut de Recerca, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0529-1719","authenticated-orcid":false,"given":"Toni","family":"Matic","sequence":"additional","affiliation":[{"name":"19Department of Pediatrics, University Hospital Center Zagreb, Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9059-0929","authenticated-orcid":false,"given":"Friso G.","family":"Calkoen","sequence":"additional","affiliation":[{"name":"20Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7647-2253","authenticated-orcid":false,"given":"Peter","family":"Svec","sequence":"additional","affiliation":[{"name":"21Bone Marrow Transplantation Unit, Department of Pediatric Hematology and Oncology, National Institute of Children's Diseases, Comenius University, Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5230-0628","authenticated-orcid":false,"given":"Roland","family":"Meisel","sequence":"additional","affiliation":[{"name":"22Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5879-0610","authenticated-orcid":false,"given":"Adriana","family":"Balduzzi","sequence":"additional","affiliation":[{"name":"23Pediatric Hematopoietic Transplant Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy"},{"name":"24School of Medicine and Surgery, University of Milan-Bicocca, Milan, 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