
Balanced rearrangements involving the KMT2A gene (KMT2Ar) are frequent in acute myeloid leukemia (AML). This study analyzed 205 adult AML patients with KMT2Ar, focusing on the prognostic implications of different fusion partners and co-occurring mutations. Overall survival (OS) did not significantly differ across various translocations, including t(9;11)(p21.3;q23.3)/KMT2A::MLLT3. However, age >60, secondary AML, and mutations in DNMT3A and KRAS independently predicted poorer OS in intensively treated patients. In younger patients with de novo AML, mutations in KRAS and TP53 significantly correlated with lower complete remission rates and inferior OS. Allogeneic stem cell transplantation in the first remission improved OS.
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