{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T03:18:16Z","timestamp":1773717496457,"version":"3.50.1"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,18]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Myeloid neoplasm post-cytotoxic therapy (MN-pCT) includes acute myeloid leukaemia (AML) arising in patients exposed to cytotoxic or radiation therapy for unrelated conditions. MN-pCT is rare in children and generally has a poor outcome. Mixed lineage leukaemia locus translocations (MLL\/KMT2A) are the most common cytogenetic abnormalities associated with topoisomerase-II inhibitor exposure in MN-pCT.<\/jats:p>\n               <jats:p>v-raf murine sarcoma viral oncogene homolog B1 (BRAF) are targetable mutations seen in &lt;1% of de novo AML, but are associated with poor prognosis. BRAF mutations are extremely rare in MN-pCT and are described in few cases in adults and have not been reported in children.<\/jats:p>\n               <jats:p>We present one such child with primary malignancy of B-ALL who was de novo ETV6\/RUNX1 positive with absent Mixed lineage leukaemia (MLL) rearrangements. He had a late central nervous system relapse followed by MN-pCT (AML-M5) post-exposure to topoisomerase-II inhibitors and craniospinal irradiation (CSI). His cytogenetic work-up revealed t(9;11)(p21-22;q23) or (MLL\/AF9) and targeted genomic sequencing revealed BRAFV600E. This case highlights the interplay of specific AML subtype, MLL rearrangement and BRAF mutation.<\/jats:p>","DOI":"10.1136\/bcr-2024-263083","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T03:43:27Z","timestamp":1743133407000},"page":"e263083","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Acute myeloid leukaemia post-cytotoxic therapy with BRAF V600E mutation in a child"],"prefix":"10.1136","volume":"18","author":[{"given":"Saisindhu","family":"Mamidala","sequence":"first","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preeti","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Pathology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Pathology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"additional","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"2025082712511970000_18.3.e263083.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"2025082712511970000_18.3.e263083.2","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2024.2329132","article-title":"Myeloid neoplasms post cytotoxic therapy: epidemiology, pathogenesis outcomes, prognostic factors, and treatment 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Oncol Hematol"},{"key":"2025082712511970000_18.3.e263083.6","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017013748"},{"key":"2025082712511970000_18.3.e263083.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1516192"},{"key":"2025082712511970000_18.3.e263083.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404009"},{"key":"2025082712511970000_18.3.e263083.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1200\/PO.16.00032","article-title":"Combined Targeted Therapy for BRAF-Mutant, Treatment-Related Acute Myeloid Leukemia","volume":"1","author":"Wander","year":"2017","journal-title":"JCO Precis Oncol"},{"key":"2025082712511970000_18.3.e263083.10","doi-asserted-by":"publisher","DOI":"10.1158\/1535-7163.MCT-10-0799"},{"key":"2025082712511970000_18.3.e263083.11","doi-asserted-by":"crossref","first-page":"4618","DOI":"10.1158\/1078-0432.CCR-21-2138","article-title":"Molecular Pathways and Mechanisms of BRAF in Cancer Therapy","volume":"28","author":"Poulikakos","year":"2022","journal-title":"Clin Cancer Res"},{"key":"2025082712511970000_18.3.e263083.12","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2402500"},{"key":"2025082712511970000_18.3.e263083.13","doi-asserted-by":"crossref","DOI":"10.1200\/EDBK_390010","article-title":"Using Measurable Residual Disease to Optimize Management of AML, ALL, and Chronic Myeloid Leukemia","volume":"43","author":"Dekker","year":"2023","journal-title":"Am Soc Clin Oncol Educ Book"}],"container-title":["BMJ Case 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