[Prognostic significance of IKZF1 alterations in acute B-lymphoblastic leukemia and the choice of transplantation strategy].

Gene alterations in Ikaros family zinc finger protein 1 (IKZF1) are common genetic abnormalities in B-cell acute lymphoblastic leukemia (B-ALL) and are closely associated with an increased risk of relapse and poor prognosis. In this study, the biological functions of the IKZF1 gene and the clinical significance of its various mutation types were systematically elaborated. Accordingly, a comprehensive clinical decision-making framework spanning from diagnosis to post-transplantation management was constructed. This framework provides an in-depth analysis of the pivotal role of immunotherapy as a "bridge" to transplantation, innovatively proposes an "MRD clearance kinetics" -guided model for deciding on transplantation modalities (allogeneic versus autologous), and defines proactive post-transplantation intervention strategies based on MRD monitoring. Furthermore, this review aims to provide a clear and actionable blueprint for individualized therapy for B-ALL patients with IKZF1 alterations.