Evidence map›Paper›PMID 42020684›Full record

ArticleInternational journal of hematology2026

Philadelphia chromosome-negative but BCR::ABL1-positive acute lymphoblastic leukemia: a real-world multicenter cohort study.

Shota Yokoyama, Masahiro Onozawa, Hiroyuki Kimura, Takahide Ara, Jun Nagai, Shota Yoshida, Naoki Miyashita, Toshihiro Matsukawa, Hideki Goto, Shinsuke Hirabayashi and 17 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in International journal of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Shota YokoyamaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Masahiro OnozawaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan. onozawa@med.hokudai.ac.jp.ORCID http://orcid.org/0000-0001-9267-2864
Hiroyuki KimuraDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Takahide AraDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Jun NagaiDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Shota YoshidaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Naoki MiyashitaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Toshihiro MatsukawaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Hideki GotoDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.
Shinsuke HirabayashiDepartment of Pediatrics, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Minoru KanayaBlood Disorders Center, Aiiku Hospital, Sapporo, Japan.
Akio MoriBlood Disorders Center, Aiiku Hospital, Sapporo, Japan.
Daisuke HidakaDepartment of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
Junichi HashiguchiDepartment of Internal Medicine, Kitami Red Cross Hospital, Kitami, Japan.
Kentaro WakasaDepartment of Hematology, Obihiro Kosei Hospital, Obihiro-Shi, Japan.
Makoto IbataDepartment of Hematology, Sapporo-Kosei General Hospital, Sapporo, Japan.
Yukari TakedaDepartment of Hematology, Tonan Hospital, Sapporo, Japan.
Takuto MiyagishimaDepartment of Hematology, Kushiro Rosai Hospital, Kushiro, Japan.
Satoshi YamamotoDepartment of Hematology, Sapporo City General Hospital, Sapporo, Japan.
Katsuya FujimotoDepartment of Hematology, NHO Hokkaido Cancer Center, Sapporo, Japan.
Toma SuzukiDepartment of Hematology, Hakodate Municipal Hospital, Hakodate, Japan.
Tomoyuki SagaDepartment of Hematology, Kin-Ikyo Chuo Hospital, Sapporo, Japan.
Hajime SakaiDepartment of Hematology, Teine Keijinkai Hospital, Sapporo, Japan.
Yasutaka KakinokiDepartment of Hematology, Asahikawa City Hospital, Asahikawa, Japan.
Tatsuo OyakeDepartment of Hematology and Oncology, Iwate Medical University, Yahaba, Japan.
Takeshi KondoBlood Disorders Center, Aiiku Hospital, Sapporo, Japan.
Takanori TeshimaDepartment of Hematology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic myelogenous leukemia that carries the BCR::ABL1 fusion gene without cytogenetically detectable Philadelphia (Ph) chromosomes is termed masked Ph. However, the prevalence and clinical relevance of masked Ph in acute lymphoblastic leukemia (ALL) remain unclear. Using the Hokkaido Leukemia Net real-world multicenter cohort, we analyzed 160 B-cell ALL patients diagnosed between 2017 and 2024 with available cytogenetic and molecular data. Among 92 BCR::ABL1-positive cases, 19 (20.7%) lacked a cytogenetically visible Ph chromosome and were classified as masked-Ph ALL. Compared with Ph + ALL, masked-Ph patients were older and had lower white blood cell counts and bone marrow blast percentages at diagnosis. Most BCR::ABL1-positive patients received tyrosine kinase inhibitors (TKIs) during induction, resulting in comparable complete remission rates and similar overall survival between masked-Ph and Ph + ALL; both groups showed superior outcomes compared with BCR::ABL1-negative ALL. The number of metaphases analyzed by G-banding was significantly lower in masked-Ph ALL, suggesting underdetection by conventional cytogenetics. One case exhibited an atypical FISH pattern consistent with a cryptic microinsertion. These findings indicate that masked-Ph ALL is relatively common and may be overlooked without molecular testing, underscoring the importance of incorporating RT-PCR and FISH at diagnosis.

Indexed as

Fusion Proteins, bcr-ablPhiladelphia ChromosomePrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentAdultAgedCohort StudiesFemaleHumansIn Situ Hybridization, FluorescenceMaleMiddle AgedProtein Kinase InhibitorsBCR-ABL1 fusion protein, humanFusion Proteins, bcr-ablProtein Kinase InhibitorsALLCryptic insertionHokkaido leukemia netMasked Ph

Identifiers

PMID42020684

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.