KMT2A-Umlagerung (MLL-Fusion)
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | BIO-KMT2A-REARRANGEMENT |
|---|---|
| Art | Biomarker |
| Aliase | 11q23 NeuordnungKMT2A-UmstellungKMT2A-rFusion MLLMLL-UmstellungПеребудова KMT2A (фузія MLL) |
| Status | reviewed 2026-04-30 | pending_clinical_signoff |
| Erkrankungen | DIS-AML DIS-B-ALL |
| Quellen | SRC-ELN-AML-2022 SRC-NCCN-AML-2025 |
Biomarker-Fakten
| Biomarker-Typ | gene_fusion |
|---|---|
| Angaben zur Mutation | {"functional_impact": "Aberrant transcriptional activation of HOX-A cluster (HOXA9 / MEIS1) via menin-MLL complex; leukemogenic", "gene": "KMT2A", "partners": ["MLLT3 (AF9, t(9;11))", "MLLT1 (ENL, t(11;19))", "AFDN (AF6, t(6;11))", "ELL, t(11;19)", "AFF1 (AF4, t(4;11))", "MLLT10 (AF10)"], "variant_type": "chromosomal rearrangement (typically 11q23 translocation)"} |
| Messung | VerfahrenKaryotyp + FISH (KMT2A Break-Apart-Sonde) bei Diagnose; RT-PCR / RNA-NGS zur Fusions-Partner-Identifikation Einheitencategorical (positive | negative); fusion partner reported when known |
| Verwandte Biomarker | BIO-NPM1 |
Anmerkungen
KMT2A rearrangements occur in ~5-10% of adult AML and ~70% of infant ALL/AML; ELN-2022 classifies as adverse risk in AML. Mechanism: KMT2A fusion proteins recruit menin to drive HOXA / MEIS1 expression — menin-MLL interaction is the therapeutic target. Revumenib (menin inhibitor; AUGMENT-101 phase 1/2) FDA-approved Nov 2024 for relapsed/ refractory KMT2A-rearranged acute leukemia (≥1 prior line). ORR ~63% with CR/CRh ~23% in KMT2A-r AML. Differentiation syndrome (~16%) and QTc prolongation are signature AEs. Ziftomenib is alternative menin inhibitor in late-phase trials. Common partners: AF9 (t(9;11)) and AF4 (t(4;11)) — diagnostic karyotype + FISH break-apart probe is standard; fusion partner identification by RT-PCR or RNA-NGS informs prognosis (some partners higher risk than others).
Verwendet von
Therapeutische Relevanz
BMA-KMT2A-REARR-AML- Revumenib (SNDX-5613), ein oraler Menin-Inhibitor, ist FDA-genehmigt (Nov 2024) für rezidivierte/r...BMA-KMT2A-REARR-B-ALL- Revumenib (Menin-Inhibitor) FDA-genehmigt (Nov 2024) für rezidivierte/refraktäre KMT2A-Rearran...