# A subtype of childhood acute lymphoblastic leukaemia with poor outcome: genome-wide classification study (BCR-ABL1-like ALL)

Source: https://onco.cc/key-papers/paper-den-boer-bcr-abl1-like-all-lancet-oncol-2009/  
OnCo record `paper-den-boer-bcr-abl1-like-all-lancet-oncol-2009` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Gene expression profiling identified a group of childhood leukaemias that look like Philadelphia-positive disease without the fusion gene, later called Ph-like or BCR-ABL1-like ALL, with a high relapse rate and frequent IKZF1 deletions.

## Summary

Genome-wide expression classification of 190 childhood B-ALL cases identifying a novel subtype in about 15 percent of B-other cases with a signature resembling BCR-ABL1-positive ALL, frequent IKZF1 deletions, and poor five-year disease-free survival (about 60 percent) validated in independent cohorts.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2009
- DOI: 10.1016/S1470-2045(08)70339-5
- Authors: Den Boer ML, van Slegtenhorst M, De Menezes RX, et al.
- Findings: BCR-ABL1-like subtype in about 15 percent of B-other childhood ALL.; Five-year disease-free survival about 60 percent, similar to BCR-ABL1-positive ALL.
- What it means: This discovery, made simultaneously with the American Children's Oncology Group finding, created the Ph-like ALL category now screened for in high-risk protocols.
- Caveats: Discovery study without kinase lesion characterisation, which came with later sequencing.

## Sources

- Lancet Oncol 2009: https://doi.org/10.1016/S1470-2045(08)70339-5
- PubMed: https://pubmed.ncbi.nlm.nih.gov/19138562/

## Connected records

- cancers: [Philadelphia chromosome-like acute lymphoblastic leukaemia (Ph-like or BCR::ABL1-like ALL)](https://onco.cc/cancers/all-ph-like/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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