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Despite improved outcomes of these children, the survival rate after relapse is extremely poor. Moreover, the survivors must also endure the acute and long-term effects of intensive therapy. Although recent studies have identified a number of recurrent genomic aberrations in pediatric T-ALL, none of the changes is known to have prognostic significance. The aim of our study was to analyze the cytogenomic changes and their various combinations in bone marrow cells of children with T-ALL and to correlate our findings with the clinical features of the subjects and their treatment responses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We performed a retrospective and prospective comprehensive cytogenomic analysis of consecutive cohort of 66 children (46 boys and 20 girls) with T-ALL treated according to BFM-based protocols and centrally investigated cytogenetics and immunophenotypes. Using combinations of cytogenomic methods (conventional cytogenetics, FISH, mFISH\/mBAND, arrayCGH\/SNP and MLPA), we identified chromosomal aberrations in vast majority of patients (91%). The most frequent findings involved the deletion of <jats:italic>CDKN2A\/CDKN2B<\/jats:italic> genes (71%), T-cell receptor (<jats:italic>TCR<\/jats:italic>) loci translocations (27%), and <jats:italic>TLX3<\/jats:italic> gene rearrangements (23%). All chromosomal changes occurred in various combinations and were rarely found as a single abnormality. Children with aberrations of <jats:italic>TCR<\/jats:italic> loci had a significantly better event free (<jats:italic>p<\/jats:italic>\u2009=\u20090.0034) and overall survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.0074), all these patients are living in the first complete remission. None of the abnormalities was an independent predictor of an increased risk of relapse.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We identified a subgroup of patients with <jats:italic>TCR<\/jats:italic> aberrations (both <jats:italic>TRA\/TRD<\/jats:italic> and <jats:italic>TRB<\/jats:italic>), who had an excellent prognosis in our cohort with 5-year EFS and OS of 100%, regardless of the presence of other abnormality or the translocation partner. Our data suggest that escalation of treatment intensity, which may be considered in subsets of T-ALL is not needed for nonHR (non-high risk) patients with TCR aberrations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13039-024-00682-4","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T23:02:48Z","timestamp":1716505368000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cytogenomic characterization of pediatric T-cell acute lymphoblastic leukemia reveals TCR rearrangements as predictive factors for exceptional prognosis"],"prefix":"10.1186","volume":"17","author":[{"given":"Libuse","family":"Lizcova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Prihodova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Pavlistova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Svobodova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Mejstrikova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondrej","family":"Hrusak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavla","family":"Luknarova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iveta","family":"Janotova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Sramkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Stary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzana","family":"Zemanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"issue":"1","key":"682_CR1","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1182\/asheducation-2016.1.580","volume":"2016","author":"EA Raetz","year":"2016","unstructured":"Raetz EA, Teachey DT. 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