KMT2A-Umlagerung (MLL-Fusion bei 11q23) bei AML — ~5-10% Prävalenz bei erwachsenen AML; ELN-20...
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | RF-AML-KMT2A-ACTIONABLE |
|---|---|
| Art | Warnhinweis |
| Status | reviewed 2026-04-30 | pending_clinical_signoff |
| Erkrankungen | DIS-AML |
| Quellen | SRC-ELN-AML-2022 SRC-NCCN-AML-2025 |
Ursprung der Roten Flagge
| Begriffsbestimmung | KMT2A rearrangement (MLL fusion at 11q23) in AML — ~5-10% prevalence in adult AML; ELN-2022 adverse-risk classifier. Revumenib (menin inhibitor; AUGMENT-101 phase 1/2) FDA-approved Nov 2024 for relapsed/ refractory KMT2A-rearranged acute leukemia after ≥1 prior line (ORR ~63%, CR/CRh ~23%). Ziftomenib alternative menin inhibitor in late-phase trials. Common partners: AF9 (t(9;11)) and AF4 (t(4;11)). |
|---|---|
| Klinische Richtung | Intensivierung |
| Kategorie | high-risk-biology |
| Schaltet Algorithmus | ALGO-AML-1L, ALGO-AML-2L |
Logik auslösen
{
"any_of": [
{
"finding": "kmt2a_rearrangement",
"value": true
},
{
"finding": "kmt2a_fusion",
"value": true
},
{
"finding": "mll_rearrangement",
"value": true
},
{
"finding": "mll_fusion",
"value": true
},
{
"finding": "kmt2a_status",
"value": "rearranged"
},
{
"finding": "karyotype_11q23",
"value": true
}
],
"type": "biomarker"
}
Anmerkungen
Detection: karyotype + FISH break-apart probe at diagnosis; RT-PCR or RNA-NGS for fusion partner identification. Differentiation syndrome on revumenib (~16%) — monitor for fever, dyspnea, weight gain, effusions; treat with dexamethasone + hold revumenib until resolution. QTc prolongation requires baseline + serial ECG with K+/Mg++ correction. AlloHCT bridge for fit responders — revumenib alone NOT curative. Algorithm wiring deferred — IND-AML-2L-KMT2A- REVUMENIB created but not yet routed by ALGO-AML-2L (would require step-restructure, out of chunk scope). MDT review during chunk rollout. STUB — requires clinical co-lead signoff.
Verwendet von
Algorithmen
ALGO-AML-2L- ALGO-AML-2L
Anwendungsgebiet
IND-AML-2L-KMT2A-REVUMENIB- IND-AML-2L-KMT2A-REVUMENIB