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Pediatric Acute Myeloid Leukemia with KMT2A rearrangement -- can Partner Gene Help Determine Need for Hematopoietic Stem Cell Transplant?
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  • Ibrahim Al Ghemlas,
  • Saadiya Khan,
  • Ibtisam AlQahtani,
  • Khawar Siddiqui,
  • Ali Al-Ahmari,
  • Hawazen AlSaedi,
  • Amal Alseraihy,
  • Abdullah Al-Jefri,
  • Awatif Alanazi,
  • Mouhab Ayas
Ibrahim Al Ghemlas
King Faisal Specialist Hospital & Research Center, Faculty of Medicine, Alfaisal University
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Saadiya Khan
King Faisal Specialist Hospital and Research Center
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Ibtisam AlQahtani
King Faisal Specialist Hospital and Research Center
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Khawar Siddiqui
King Faisal Sepcialist Hospital & Research Center
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Ali Al-Ahmari
King Faisal Specialist Hospital&research centre
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Hawazen AlSaedi
King Faisal Specialist Hospital and Research Center
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Amal Alseraihy
King Faisal Specialist Hospital & Research Center
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Abdullah Al-Jefri
King Faisal Specialist Hospital & Research Center
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Awatif Alanazi
King Faisal Specialist Hospital and Research Center
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Mouhab Ayas
King Faisal Specialist Hospital & Research Center
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Abstract

Objective: Pediatric acute myeloid leukemia (AML) with KMT2A rearrangement is seen in 15-20% of patients. KMT2A has been shown to rearrange with more than 80 distinct partner genes. In this study we examined the pattern of the various KMT2A rearrangements and their treatment outcomes in our patient population. Methods: We retrospectively analyzed pediatric AML patients with KMT2A rearrangement seen in our institution between January 2005 and December 2015. Results: There were 18 evaluable patients with equal genders. The median age was 4.12 years (range 0-13.5). FAB classification M5 was the most common morphology. Common translocation partner was KMT2A/MLLT3. Ten patients were treated with chemotherapy only and 8 with hematopoietic stem cell transplantation (HSCT). There were 50% patients alive in each group. Conclusion: KMT2A patients can be treated with both chemotherapy and HSCT. The different fusion partners can lead to heterogeneous outcomes in children with KMT2A rearranged AML. Further prospective studies are needed to delineate the high-risk sub-sets in KMT2A rearranged AML that will benefit from HSCT.