{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:38:51Z","timestamp":1793335131604,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute myeloid leukemia (AML) with rearrangement <jats:italic>of lysine methyltransferase 2a<\/jats:italic> gene (<jats:italic>KMT2Ar<\/jats:italic>) is characterized by chemotherapy resistance and high rates of relapse. However, additional causes of treatment failure or early mortality have not been well\u2010defined in this entity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective analysis, causes and rates of early mortality following induction treatment were compared between a cohort of adults with <jats:italic>KMT2Ar<\/jats:italic> AML (<jats:italic>N<\/jats:italic>\u00a0=\u00a0172) and an age\u2010matched cohort of patients with normal karyotype AML (<jats:italic>N<\/jats:italic>\u00a0=\u00a0522).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 60\u2010day mortality in patients with <jats:italic>KMT2Ar<\/jats:italic> AML was 15% compared with 7% with normal karyotype (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). We found a significantly higher occurrence of major bleeding events (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.005) and total bleeding events (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001) in <jats:italic>KMT2Ar<\/jats:italic> AML compared with diploid AML. Among evaluable patients with <jats:italic>KMT2Ar<\/jats:italic> AML, 93% exhibited overt disseminated intravascular coagulopathy compared with 54% of patients with a normal karyotype before death (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.03). In a multivariate analysis, <jats:italic>KMT2Ar<\/jats:italic> and a monocytic phenotypic were the only independent predictors of any bleeding event in patients who died within 60\u00a0days (odds ratio, 3.5; 95% CI, 1.4\u201310.4; <jats:italic>p<\/jats:italic>\u00a0= .03; odds ratio, 3.2; 95% CI, 1\u20131\u20109.4; <jats:italic>p<\/jats:italic>\u00a0= .04, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, early recognition and aggressive management of disseminated intravascular coagulopathy and coagulopathy are important considerations that could mitigate the risk of death during induction treatment in <jats:italic>KMT2Ar<\/jats:italic> AML.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Acute myeloid leukemia (AML) with rearrangement of <jats:italic>KMT2A<\/jats:italic> is characterized by chemotherapy resistance and high rates of relapse. However, additional causes of treatment failure or early mortality have not been well\u2010defined in this entity.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>In this article, that <jats:italic>KMT2A<\/jats:italic>\u2010rearranged AML is demonstrably associated with higher early mortality and an increased risk of bleeding and coagulopathy, specifically, disseminated intravascular coagulation, compared with normal karyotype AML.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>These findings emphasize the importance of monitoring and mitigating coagulopathy in <jats:italic>KMT2A<\/jats:italic>\u2010rearranged leukemia similar to what is done in acute promyelocytic leukemia.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34728","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T11:56:16Z","timestamp":1678362976000},"page":"1856-1865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Early mortality in acute myeloid leukemia with <i>KMT2A<\/i> rearrangement is associated with high risk of bleeding and disseminated intravascular coagulation"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3157-8107","authenticated-orcid":false,"given":"Daniel","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Medicine McGovern Medical School The University of Texas Health Science Center at Houston  Houston Texas USA"},{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas 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