{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:55:03Z","timestamp":1790708103774,"version":"4.1.0"},"reference-count":38,"publisher":"American Society of Hematology","issue":"8","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>In adults with Philadelphia chromosome\u2013negative (Ph\u2212) acute lymphoblastic leukemia (ALL) genetic risk is usually combined with measurable residual disease (MRD) assignment to consolidation therapy. However, this combination is not uniform across trials and centralized assessment is not always performed. This study analyzed patient outcomes using centrally assessed MRD and genetics. Patients with high genetic risk (HGR), those who required 2 induction cycles for complete remission (CR), and patients with CR with end-of-induction (EOI) MRD of \u22650.01% were assigned to allogeneic hematopoietic stem cell transplant (allo-HSCT), whereas the remaining patients were assigned to delayed consolidation and maintenance. HGR for B-cell ALL included KMT2A rearrangements, low hypodiploidy and age of &amp;gt;35 years, homozygous TP53 mutations\/deletions, or concomitant IKZF1 and CDKN2A\/B deletions. HGR in T-cell ALL (T-ALL) included absence of NOTCH1\/FBXW7 mutations and\/or K\/NRAS or PTEN alterations. Patients with early T-cell precursor (ETP) ALL received a different induction regimen, and all were assigned to allo-HSCT. Median age of 436 patients was 39 years (range, 18-60), 332 with B-lineage ALL and 104 with T-ALL. By intention to treat, 243 patients without ETP ALL (61%) were assigned to allo-HSCT and 157 (39%) to chemotherapy. The 3-year overall survival (OS) probability was 64% (95% confidence interval [CI], 58-69). For patients with CR and EOI MRD of &amp;lt;0.01% without HGR (n = 109), the OS probability was 81% (95% CI, 70-89), compared with 50% (95% CI, 34-63) for MRD-negative patients with HGR (n = 64). In patients with ETP ALL, the probability of 3-year OS was 61% (95% CI, 37-79). The combination of genetics and MRD allows accurate identification of adult patients with Ph\u2212 ALL who are candidates for allo-HSCT or chemotherapy. This trial was registered at www.clinicaltrials.gov as NCT04179929.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2025032645","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:21:31Z","timestamp":1777915291000},"page":"939-956","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":3,"title":["Genetics and MRD for therapy allocation in adults with Philadelphia chromosome\u2013negative acute lymphoblastic leukemia"],"prefix":"10.1182","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1042-6024","authenticated-orcid":false,"given":"Josep-Maria","family":"Ribera","sequence":"first","affiliation":[{"name":"1Hematology Department, Institut Catal\u00e0 d\u2019Oncologia\u2013Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Aut\u00f2noma de Barcelona, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Torrent","sequence":"additional","affiliation":[{"name":"1Hematology Department, Institut Catal\u00e0 d\u2019Oncologia\u2013Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Aut\u00f2noma de Barcelona, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-2534","authenticated-orcid":false,"given":"Mireia","family":"Morgades","sequence":"additional","affiliation":[{"name":"1Hematology Department, Institut Catal\u00e0 d\u2019Oncologia\u2013Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Aut\u00f2noma de Barcelona, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5207-8796","authenticated-orcid":false,"given":"Susana","family":"Barrena","sequence":"additional","affiliation":[{"name":"2Centro de Investigaci\u00f3n del C\u00e1ncer, Instituto de Biolog\u00eda Molecular y Celular del C\u00e1ncer\u2013Consejo Superior de Investigaciones Cient\u00edficas, and Servicio de Citometr\u00eda, Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain, and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de C\u00e1ncer, Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Ribera","sequence":"additional","affiliation":[{"name":"3Josep Carreras Leukemia Research Institute, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5657-4842","authenticated-orcid":false,"given":"Eul\u00e0lia","family":"Genesc\u00e0","sequence":"additional","affiliation":[{"name":"3Josep Carreras Leukemia Research Institute, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-067X","authenticated-orcid":false,"given":"Jos\u00e9","family":"Gonz\u00e1lez-Campos","sequence":"additional","affiliation":[{"name":"4Hematology Department, Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla\/Consejo Superior de Investigaciones Cient\u00edficas\/Centro de investigaci\u00f3n Biom\u00e9dica en Red-Cance, Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8688-1202","authenticated-orcid":false,"given":"N\u00faria","family":"Mart\u00ednez-Cibrian","sequence":"additional","affiliation":[{"name":"5Hematology Department, Hospital Cl\u00ednic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3275-5593","authenticated-orcid":false,"given":"Pau","family":"Montesinos","sequence":"additional","affiliation":[{"name":"6Hematology Department, Hospital Universitari i Polit\u00e8cnic La Fe, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-3096","authenticated-orcid":false,"given":"Alberto","family":"Hern\u00e1ndez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"7Hematology Department, Hospital Universitario de Salamanca, Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca, Instituto de Biolog\u00eda Molecular y Celular del C\u00e1ncer, Consejo Superior de Investigaciones Cient\u00edficas, Centro de Investigaci\u00f3n del C\u00e1ncer, Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Barba","sequence":"additional","affiliation":[{"name":"8Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Zapico","sequence":"additional","affiliation":[{"name":"9Biochemical Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6383-0381","authenticated-orcid":false,"given":"Ricardo","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"10Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigaci\u00f3n Hospital 12 de Octubre (i+12), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Novo","sequence":"additional","affiliation":[{"name":"11Hematology Department, Hospital Son Espases, Palma de 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo-Javier","family":"Gonz\u00e1lez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"21Hematology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2994-9055","authenticated-orcid":false,"given":"Irene","family":"Garc\u00eda-Cadenas","sequence":"additional","affiliation":[{"name":"22Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodr\u00edguez-Medina","sequence":"additional","affiliation":[{"name":"23Hematology Department, Hospital Universitario de Gran Canaria Doctor Negr\u00edn, Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Mart\u00ednez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"24Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arancha","family":"Berm\u00fadez","sequence":"additional","affiliation":[{"name":"25Hematology Department, Hospital Universitario Marqu\u00e9s de Valdecilla, Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"G\u00f3mez-Centuri\u00f3n","sequence":"additional","affiliation":[{"name":"26Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8719-7165","authenticated-orcid":false,"given":"Mar\u00eda","family":"Herrero","sequence":"additional","affiliation":[{"name":"2Centro de Investigaci\u00f3n del 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C\u00f3rdoba, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-7954","authenticated-orcid":false,"given":"Jos\u00e9-\u00c1ngel","family":"Raposo","sequence":"additional","affiliation":[{"name":"29Hematology Department, Hospital Puerta del Mar, C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8949-8762","authenticated-orcid":false,"given":"Laura","family":"Sol\u00e1n","sequence":"additional","affiliation":[{"name":"30Hematology Department, Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Rold\u00e1n-Galiacho","sequence":"additional","affiliation":[{"name":"31Hematology Department, Hospital Universitario de Cruces, Barakaldo, 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