{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:23:18Z","timestamp":1787242998276,"version":"build-2736575974"},"reference-count":25,"publisher":"American Society of Hematology","issue":"8","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,20]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Large-scale sequencing efforts have defined up to 27 diagnostic subtypes in B-cell precursor acute lymphoblastic leukemia (B-ALL), leaving few samples unclassified. Extended genomic and transcriptomic profiling in routine diagnostics broadens the sample collection, enabling identification of novel subtypes. We analyzed 4857 patients with B-ALL from 3 cohorts and identified a group of 20 patients (age, 18-66 years; median, 34 years) characterized by a previously undescribed IGH::FENDRR rearrangement exclusive to this subtype (n = 17\/20), KRAS p.A146T\/V\/P mutations (n = 17\/20 vs n = 86\/4857; P&amp;lt; .001), and distinct DNA methylation\/gene expression profiles, including overexpression of the lncRNA FENDRR and the transcription factor FOXF1 (FOXF1\/FENDRR) as well as JAK\/STAT and RAS\/MAPK signaling signatures. A gene expression machine learning classifier accurately identified FOXF1\/FENDRR cases in 2 independent cohorts. Patients treated according to German Multicenter Study Group for Adult ALL (GMALL)\/Group for Research in Adult ALL (GRAALL) protocols showed very poor chemotherapy response with 8 of 13 exhibiting induction failure or minimal residual disease (MRD) \u226510\u22123 and 8 of 12 remaining MRD positive after first consolidation\/salvage. Intensification including blinatumomab (n = 10) and\/or allogeneic stem cell transplantation (n = 12) resulted in ongoing molecular remission in 13 of 16 patients. FOXF1\/FENDRR represents a novel B-ALL subtype which might benefit from early immunotherapeutic treatment or targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2025031102","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:57:43Z","timestamp":1774630663000},"page":"1026-1032","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":1,"title":["<i>IGH<\/i>\n                    ::\n                    <i>FENDRR<\/i>\n                    and specific\n                    <i>KRAS<\/i>\n                    mutations define a novel B-ALL molecular subtype with poor chemotherapy response"],"prefix":"10.1182","volume":"148","author":[{"given":"Sonja","family":"Bendig","sequence":"first","affiliation":[{"name":"1Medical Department II, Hematology\/Oncology, University Hospital Schleswig-Holstein, Kiel, Germany"},{"name":"2Clinical Research Unit \u2018CATCH ALL\u2019 (KFO 5010), Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0638-0000","authenticated-orcid":false,"given":"Alina M.","family":"Hartmann","sequence":"additional","affiliation":[{"name":"1Medical Department II, Hematology\/Oncology, University Hospital Schleswig-Holstein, Kiel, Germany"},{"name":"2Clinical Research Unit \u2018CATCH ALL\u2019 (KFO 5010), Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Wessels","sequence":"additional","affiliation":[{"name":"1Medical Department II, Hematology\/Oncology, University Hospital Schleswig-Holstein, Kiel, Germany"},{"name":"3Children's Cancer Institute, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2278-5054","authenticated-orcid":false,"given":"Thomas","family":"Beder","sequence":"additional","affiliation":[{"name":"1Medical Department II, Hematology\/Oncology, 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