{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:54:44Z","timestamp":1790765684191,"version":"4.1.0"},"reference-count":27,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Significant progress has been achieved in the treatment of children with myeloid leukemia associated with Down syndrome (ML-DS). We aimed to evaluate treatment outcomes and prognostic factors in children with ML-DS treated in Poland. Methods: Thirty-six children with ML-DS treated at pediatric hematology and oncology centers in Poland according to the ML-DS 2006 protocol based on the AML-BFM backbone between 2015 and 2024 were retrospectively analyzed. Results: The estimated 5-year event-free survival (EFS) and overall survival (OS) were 84.3% (95%CI: 72.5\u201398.1%) and 87.9% (77.4\u201399.8%), respectively. Although children with a complex karyotype showed numerically lower survival estimates than those with isolated constitutional trisomy 21 or additional cytogenetic abnormalities (OS: 60% [95%CI: 29.3\u2013100%] vs. 90% [73.2\u2013100%] vs. 92.3% [78.9\u2013100%], p = 0.24; EFS: 60% [95%CI: 29.3\u2013100%) vs. 75% [49.6\u2013100%] vs. 92.3% [78.9\u2013100%], p = 0.26), p = 0.26), these differences were not statistically significant. MRD positivity (\u22650.1%) after the second induction cycle was identified as an adverse prognostic factor in the univariable analysis (HR = 31.1, 95%CI: 2.74\u2013353.2; p = 0.006). Conclusions: Persistent MRD positivity after the second induction cycle may identify children with ML-DS at increased risk of treatment failure. Larger multicenter studies are needed to validate the prognostic significance of MRD and recurrent molecular alterations to optimize risk-adapted treatment strategies.<\/jats:p>","DOI":"10.3390\/jcm15197548","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7548","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Outcomes and Prognostic Factors in Children with Myeloid Leukemia Associated with Down Syndrome: A Nationwide Polish Retrospective Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1212-7629","authenticated-orcid":false,"given":"Katarzyna","family":"Pawi\u0144ska-W\u0105sikowska","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-683 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1277-6810","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Czoga\u0142a","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-683 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Karolina","family":"Bukowska-Strakova","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Teofila","family":"Ksi\u0105\u017cek","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6057-479X","authenticated-orcid":false,"given":"Agnieszka","family":"Pac","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-034 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Magdalena","family":"Samborska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Jacek","family":"Wachowiak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Anna","family":"Tomo\u0144","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, 35-301 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-9142","authenticated-orcid":false,"given":"Rados\u0142aw","family":"Chaber","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, 35-301 Rzeszow, Poland"},{"name":"Department of Pediatrics, Institute of Medical Sciences, Medical College, University of Rzeszow, 35-310 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Karolina","family":"Zielezi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Hemato-Oncology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Tomasz","family":"Urasi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Hemato-Oncology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Anna","family":"Rodziewicz-Konarska","sequence":"additional","affiliation":[{"name":"Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1174-5799","authenticated-orcid":false,"given":"Krzysztof","family":"Ka\u0142wak","sequence":"additional","affiliation":[{"name":"Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Marta","family":"Koz\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Ninela","family":"Irga-Jaworska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Bartosz","family":"Chy\u017cy\u0144ski","sequence":"additional","affiliation":[{"name":"Departament and Clinic of Oncology, Pediatric Hematology, Clinical Transplantology and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-5236","authenticated-orcid":false,"given":"Pawe\u0142","family":"\u0141aguna","sequence":"additional","affiliation":[{"name":"Departament and Clinic of Oncology, Pediatric Hematology, Clinical Transplantology and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9551-2145","authenticated-orcid":false,"given":"Katarzyna","family":"Muszy\u0144ska-Ros\u0142an","sequence":"additional","affiliation":[{"name":"Departament of Pediatrics, Oncology and Hematology, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Paulina","family":"Deleszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7207-156X","authenticated-orcid":false,"given":"Joanna","family":"Zawitkowska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Monika","family":"Lejman","sequence":"additional","affiliation":[{"name":"Independent Laboratory of Genetic Diagnostic, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8916-683X","authenticated-orcid":false,"given":"Katarzyna","family":"Bobeff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, 91-738 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-5851","authenticated-orcid":false,"given":"Wojciech","family":"M\u0142ynarski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, 91-738 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Katarzyna","family":"Mycko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Hematology and Oncology, Province Children\u2019s Hospital, 10-561 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Wanda","family":"Badowska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Hematology and Oncology, Province Children\u2019s Hospital, 10-561 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Robert","family":"D\u0119bski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Immunology and Transplantology, Collegium Medicum, Nicolaus Copernicus University Torun, 85-094 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3158-119X","authenticated-orcid":false,"given":"Jan","family":"Styczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Immunology and Transplantology, Collegium Medicum, Nicolaus Copernicus University Torun, 85-094 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Weronika","family":"Stolpa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical University of Silesia, Upper Silesia Children\u2019s Care Health Centre, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Mizia-Malarz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical University of Silesia, Upper Silesia Children\u2019s Care Health Centre, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Walentyna","family":"Balwierz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-683 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6867-2717","authenticated-orcid":false,"given":"Szymon","family":"Skocze\u0144","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-683 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1055\/a-1532-2016","article-title":"Recommendations for Diagnosis and Treatment of Children with Transient Abnormal Myelopoiesis (TAM) and Myeloid Leukemia in Down Syndrome (ML-DS)","volume":"233","author":"Golnik","year":"2021","journal-title":"Klin. Padiatr."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kosmidou, A., Tragiannidis, A., and Gavriilaki, E. (2023). Myeloid Leukemia of Down Syndrome. Cancers, 15.","DOI":"10.3390\/cancers15133265"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3352","DOI":"10.1038\/s41375-021-01414-y","article-title":"Clinical and biological aspects of myeloid leukemia in Down syndrome","volume":"35","author":"Boucher","year":"2021","journal-title":"Leukemia"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Egan, G., Chopra, Y., Mourad, S., Chiang, K.Y., and Hitzler, J. (2021). Treatment of acute myeloid leukemia in children: A practical perspective. Pediatr. Blood Cancer, 68.","DOI":"10.1002\/pbc.28979"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1586\/17474086.2014.959923","article-title":"Prognosis and management of acute myeloid leukemia in patients with Down syndrome","volume":"7","author":"Caldwell","year":"2014","journal-title":"Expert Rev. Hematol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1182\/blood.V80.9.2210.2210","article-title":"Acute myeloid leukemia (AML) in Down\u2019s syndrome is highly responsive to chemotherapy: Experience on Pediatric Oncology Group AML Study 8498","volume":"80","author":"Ravindranath","year":"1992","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6532","DOI":"10.1182\/bloodadvances.2022009381","article-title":"Survival outcomes of children with relapsed or refractory myeloid leukemia associated with Down syndrome","volume":"7","author":"Raghuram","year":"2023","journal-title":"Blood Adv."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Miladinovic, M., Reinhardt, D., Hasle, H., Goemans, B.F., Tomizawa, D., Hitzler, J., and Klusmann, J.H. (2024). Guideline for treating relapsed or refractory myeloid leukemia in children with Down syndrome. Pediatr. Blood Cancer, 71.","DOI":"10.1002\/pbc.31141"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1111\/j.1365-2141.2005.05906.x","article-title":"Treatment for myeloid leukaemia of Down syndrome: Population-based experience in the UK and results from the Medical Research Council AML 10 and AML 12 trials","volume":"132","author":"Rao","year":"2006","journal-title":"Br. J. Haematol."},{"key":"ref_10","first-page":"608","article-title":"Distinctive demography, biology, and outcome of acute myeloid leukemia and myelodysplastic syndrome in children with Down syndrome: Children\u2019s Cancer Group Studies 2861 and 2891","volume":"91","author":"Lange","year":"1998","journal-title":"Blood"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1038\/sj.leu.2403814","article-title":"AML patients with Down syndrome have a high cure rate with AML-BFM therapy with reduced dose intensity","volume":"19","author":"Creutzig","year":"2005","journal-title":"Leukemia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00277-005-0045-5","article-title":"Optimal treatment intensity in children with Down syndrome and myeloid leukaemia: Data from 56 children treated on NOPHO-AML protocols and a review of the literature","volume":"85","author":"Abildgaard","year":"2006","journal-title":"Ann. Hematol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3304","DOI":"10.1182\/blood-2017-01-764324","article-title":"Improved outcomes for myeloid leukemia of Down syndrome: A report from the Children\u2019s Oncology Group AAML0431 trial","volume":"129","author":"Taub","year":"2017","journal-title":"Blood"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1182\/blood-2017-01-765057","article-title":"Therapy reduction in patients with Down syndrome and myeloid leukemia: The international ML-DS 2006 trial","volume":"129","author":"Uffmann","year":"2017","journal-title":"Blood"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/pbc.22943","article-title":"Continuous and high-dose cytarabine combined chemotherapy in children with down syndrome and acute myeloid leukemia: Report from the Japanese children\u2019s cancer and leukemia study group (JCCLSG) AML 9805 down study","volume":"57","author":"Taga","year":"2011","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1182\/blood.2021012206","article-title":"High-dose AraC is essential for the treatment of ML-DS independent of postinduction MRD: Results of the COG AAML1531 trial","volume":"138","author":"Hitzler","year":"2021","journal-title":"Blood"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/pbc.25789","article-title":"Preserved High Probability of Overall Survival with Significant Reduction of Chemotherapy for Myeloid Leukemia in Down Syndrome: A Nationwide Prospective Study in Japan","volume":"63","author":"Taga","year":"2016","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4806","DOI":"10.1002\/cncr.27484","article-title":"Favorable survival maintained in children who have myeloid leukemia associated with Down syndrome using reduced-dose chemotherapy on Children\u2019s Oncology Group trial A2971: A report from the Children\u2019s Oncology Group","volume":"118","author":"Sorrell","year":"2012","journal-title":"Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Czogala, M., Pawinska-Wasikowska, K., Ksiazek, T., Sikorska-Fic, B., Matysiak, M., Skalska-Sadowska, J., Wachowiak, J., Rodziewicz-Konarska, A., Chybicka, A., and Myszynska-Roslan, K. (2020). Retrospective Analysis of the Treatment Outcome in Myeloid Leukemia of Down Syndrome in Polish Pediatric Leukemia and Lymphoma Study Group From 2005 to 2019. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00277"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.3324\/haematol.2023.283225","article-title":"Down syndrome and leukemia: From basic mechanisms to clinical advances","volume":"108","author":"Baruchel","year":"2023","journal-title":"Haematologica"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1182\/blood.2025030775","article-title":"CPX-351 in Down syndrome-associated Myeloid Leukemia: Results and Prognostic Factors from the Phase 3 ML-DS 2018 Trial","volume":"147","author":"Laszig","year":"2025","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1182\/blood.2023022247","article-title":"Landscape of driver mutations and their clinical effects on Down syndrome-related myeloid neoplasms","volume":"143","author":"Sato","year":"2024","journal-title":"Blood"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1182\/bloodadvances.2025017837","article-title":"Molecular Risk Markers Define Risk of Relapse in Myeloid Leukemia of Down syndrome Beyond Measurable Residual Disease","volume":"10","author":"Berman","year":"2025","journal-title":"Blood Adv."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kim, B., Yun, W., Lee, S.T., Choi, J.R., Yoo, K.H., Koo, H.H., Jung, C.W., and Kim, S.H. (2020). Prevalence and clinical implications of germline predisposition gene mutations in patients with acute myeloid leukemia. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-71386-z"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1002\/pbc.20416","article-title":"Mutation analysis of SBDS in pediatric acute myeloblastic leukemia","volume":"45","author":"Dror","year":"2005","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kennedy, A.L., Myers, K.C., Bowman, J., Gibson, C.J., Camarda, N.D., Furutani, E., Muscato, G.M., Klein, R.H., Ballotti, K., and Liu, S. (2021). Distinct genetic pathways define pre-malignant versus compensatory clonal hematopoiesis in Shwachman-Diamond syndrome. Nat. Commun., 12.","DOI":"10.1038\/s41467-021-21588-4"},{"key":"ref_27","first-page":"80","article-title":"Pan-cancer analysis reveals that CTC1-STN1-TEN1 (CST) complex may have a key position in oncology","volume":"262\u2013263","author":"Viana","year":"2022","journal-title":"Cancer Genet."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7548\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:54:46Z","timestamp":1790762086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":27,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197548"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197548","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}