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While KMT2A fusion proteins drive leukemogenesis through transcriptional dysregulation, recent discoveries have highlighted the pivotal role of non\u2010coding RNAs (ncRNAs) in shaping the molecular and epigenetic landscape of this disease. These key regulators of gene expression influence chromatin dynamics, transcriptional activation, and post\u2010transcriptional control. Circular RNAs (circRNAs) contribute to genome instability and facilitate chromosomal translocations, while some fusion\u2010derived circRNAs (f\u2010circRNAs) sustain oncogenic signaling and promote chemoresistance. Long non\u2010coding RNAs (lncRNAs) orchestrate transcriptional programs that maintain leukemic stem cell properties and reinforce aberrant self\u2010renewal pathways. MicroRNAs (miRNAs) modulate critical oncogenic networks by regulating KMT2A fusion transcripts and downstream effectors, thereby impacting drug resistance, apoptosis, and proliferation. Meanwhile, enhancer RNAs (eRNAs) fine\u2010tune transcriptional activity and epigenetic regulation, influencing KMT2A target gene expression and chromatin accessibility. Collectively, these ncRNAs integrate into the complex regulatory circuits of\n                    <jats:italic>KMT2A<\/jats:italic>\n                    \u2010r ALL, revealing their potential as biomarkers for disease classification, risk stratification, and treatment response prediction. Understanding their interplay with KMT2A fusion proteins not only provides new insights into leukemogenesis but also highlights promising opportunities for therapeutic intervention and precision medicine in this high\u2010risk leukemia subtype.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70283","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T14:53:53Z","timestamp":1765205633000},"page":"2003-2012","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The hidden regulators: Non\u2010coding\n                    <scp>RNAs<\/scp>\n                    in\n                    <scp>\n                      <i>KMT2A<\/i>\n                    <\/scp>\n                    \u2010rearranged acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4922-3427","authenticated-orcid":false,"given":"Maria 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