{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T12:58:03Z","timestamp":1768309083684,"version":"3.49.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n \n The prognostic impact of\n EVI1<\/jats:italic>\n expression in B-cell acute lymphoblastic leukemia (B-ALL) remains to be explored.\n <\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n Bone marrow (BM) samples collected from 436 consecutive newly diagnosed adult Ph-negative B-ALL patients were tested for\n EVI1<\/jats:italic>\n transcript levels using real-time quantitative PCR.\n <\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n \n The median\n EVI1<\/jats:italic>\n transcript level in the whole cohort was 0.40% (range: 0.0030\u201394.3%). Low\n EVI1<\/jats:italic>\n expression defined by lower three quartiles (\n EVI1<\/jats:italic>\n transcript levels was 2.3%) was significantly related to poorer relapse-free survival (RFS) and overall survival (OS) (\n p<\/jats:italic>\n \u202f=\u202f0.0010 and &lt; 0.0001) and was an independent adverse prognostic factor for RFS (HR (95% confidence interval): 2.3 (1.2\u20134.1),\n p<\/jats:italic>\n \u202f=\u202f0.0070) and OS (HR (95% CI): 2.5 (1.3\u20135.1),\n p<\/jats:italic>\n \u202f=\u202f0.0090) in the whole cohort. The optimal thresholds for\n EVI1<\/jats:italic>\n transcript levels in the fusion gene subgroups were determined individually, and low\n EVI1<\/jats:italic>\n expression was related to or tended to be related to poorer RFS in patients with\n TCF3::PBX1<\/jats:italic>\n ,\n Ph-like<\/jats:italic>\n fusions,\n MEF2D<\/jats:italic>\n fusions, and\n ZNF384<\/jats:italic>\n fusions groups (\n p<\/jats:italic>\n \u202f=\u202f0.0047, 0.025, 0.032, and 0.070) and was associated with poorer OS in\n ZNF384<\/jats:italic>\n fusions groups (\n p<\/jats:italic>\n \u202f=\u202f0.012), respectively. Furthermore, patients with\n TCF3::PBX1<\/jats:italic>\n or\n MEF2D<\/jats:italic>\n fusion and high\n EVI1<\/jats:italic>\n expression had RFS and OS similar to those without the corresponding fusions, and patients with\n ZNF384<\/jats:italic>\n fusion and low\n EVI1<\/jats:italic>\n expression had RFS and OS comparable to those without\n ZNF384<\/jats:italic>\n fusions (all\n p<\/jats:italic>\n \u202f&gt;\u202f0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Low\n EVI1<\/jats:italic>\n transcript levels at diagnosis are related to poor prognosis in adult Ph-negative B-ALL, and\n EVI1<\/jats:italic>\n expression may improve fusion gene-defined risk stratification.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1701539","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:34:51Z","timestamp":1768286091000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low EVI1 expression at diagnosis identifies a high-risk subgroup in adult Ph-negative B-cell acute lymphoblastic 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