{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:22:23Z","timestamp":1792027343302,"version":"4.4.0"},"reference-count":36,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"16","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> A previous study by the International Berlin-Frankfurt-M\u00fcnster Study Group (I-BFM-SG) on childhood KMT2A-rearranged ( KMT2A-r) AML demonstrated the prognostic value of the fusion partner. This I-BFM-SG study investigated the value of flow cytometry-based measurable residual disease (flow-MRD) and evaluated the benefit of allogeneic stem-cell transplantation (allo-SCT) in first complete remission (CR1) in this disease. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> A total of 1,130 children with KMT2A-r AML, diagnosed between January 2005 and December 2016, were assigned to high-risk (n = 402; 35.6%) or non\u2013high-risk (n = 728; 64.4%) fusion partner-based groups. Flow-MRD levels at both end of induction 1 (EOI1) and 2 (EOI2) were available for 456 patients and were considered negative (&lt;0.1%) or positive (\u22650.1%). End points were 5-year event-free survival (EFS), cumulative incidence of relapse (CIR), and overall survival (OS). <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> The high-risk group had inferior EFS (30.3% high risk v 54.0% non-high risk; P &lt; .0001), CIR (59.7% v 35.2%; P &lt; .0001), and OS (49.2% v 70.5%; P &lt; .0001). EOI2 MRD negativity was associated with superior EFS (n = 413; 47.6% MRD negativity v n = 43; 16.3% MRD positivity; P &lt; .0001) and OS (n = 413; 66.0% v n = 43; 27.9%; P &lt; .0001), and showed a trend toward lower CIR (n = 392; 46.1% v n = 26; 65.4%; P = .016). Similar results were obtained for patients with EOI2 MRD negativity within both risk groups, except that within the non\u2013high-risk group, CIR was comparable with that of patients with EOI2 MRD positivity. Allo-SCT in CR1 only reduced CIR (hazard ratio, 0.5 [95% CI, 0.4 to 0.8]; P = .00096) within the high-risk group but did not improve OS. In multivariable analyses, EOI2 MRD positivity and high-risk group were independently associated with inferior EFS, CIR, and OS. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> EOI2 flow-MRD is an independent prognostic factor and should be included as risk stratification factor in childhood KMT2A-r AML. Treatment approaches other than allo-SCT in CR1 are needed to improve prognosis. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.22.02120","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T20:00:20Z","timestamp":1680206420000},"page":"2963-2974","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":63,"title":["Measurable Residual Disease and Fusion Partner Independently Predict Survival and Relapse Risk in Childhood <i>KMT2A<\/i>-Rearranged Acute Myeloid Leukemia: A Study by the International Berlin-Frankfurt-M\u00fcnster Study Group"],"prefix":"10.1200","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-5126","authenticated-orcid":false,"given":"Romy E.","family":"van Weelderen","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit 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