{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:54:25Z","timestamp":1761738865202,"version":"build-2065373602"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"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. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to analyze the clinical features and prognostic significance of different fusion gene subtypes in pediatric patients with acute lymphoblastic leukaemia (ALL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data from 132 childhood patients with ALL diagnosed between 2016 and 2025 were retrospectively analyzed. Patients were categorized based on fusion gene status: TEL::AML1, BCR::ABL, E2A::PBX1, MLL::AF4, SIL::TAL1, other, negative and unknown. Clinical characteristics, laboratory findings, treatment responses, minimal residual disease status and survival outcomes were compared among different fusion gene groups. Survival analyses included overall survival (OS), event-free survival (EFS) and recurrence-free survival using the Kaplan\u2013Meier method and Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 132 patients, the fusion gene distribution was as follows: negative (48.5%), unknown (32.6%), TEL::AML1 (7.6%), BCR::ABL (3.8%), E2A::PBX1 (3.0%), MLL::AF4 (2.3%), other (1.5%) and SIL::TAL1 (0.8%). B-cell immunophenotype predominated (88.6%). E2A::PBX1-positive patients showed the most favorable outcomes with 100% 5-year OS and EFS. TEL::AML1-positive patients demonstrated good prednisone responses (90%), with 90% 5-year OS. BCR::ABL and MLL::AF4 cases presented with elevated white blood cell counts (median 86.9 and 96.5 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L, respectively), higher lactate dehydrogenase levels and inferior treatment responses. In multivariate analysis, poor prednisone response (hazard ratio [HR] = 3.41,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005) and high-risk classification (HR = 4.92,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) were independent adverse prognostic factors for EFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fusion gene abnormalities significantly influence the clinical presentation and prognosis of childhood ALL. E2A::PBX1 and TEL::AML1 demonstrate favorable outcomes, whereas BCR::ABL, MLL::AF4 and SIL::TAL1 are associated with unfavorable prognosis. These findings provide valuable insights for risk stratification and treatment optimization in pediatric ALL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1616686","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T05:29:51Z","timestamp":1761715791000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and prognostic analysis of different fusion gene abnormalities in childhood acute lymphoblastic 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