KMT2A

Chr 11AD

lysine methyltransferase 2A

Also known as: ALL-1, ALL1, CXXC7, GAS7, HRX, HTRX, HTRX1, MLL

This protein functions as a histone H3 lysine 4 methyltransferase that regulates gene expression during early development by mediating chromatin modifications associated with transcriptional activation, including regulation of HOX genes. Mutations cause Wiedemann-Steiner syndrome through an autosomal dominant inheritance pattern, predominantly through loss-of-function mechanisms. The gene shows extreme intolerance to loss-of-function variants, supporting haploinsufficiency as the primary disease mechanism.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt, Mechanism
LOFmechanismADLOEUF 0.071 OMIM phenotype
Clinical SummaryKMT2A
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Gene-Disease Validity (ClinGen)
Wiedemann-Steiner syndrome · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 1.00). One damaged copy is likely sufficient to cause disease.
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ClinVar Variants
27 unique Pathogenic / Likely Pathogenic· 194 VUS of 400 total submissions
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Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — KMT2A
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Dual constrained — LoF & missense intolerant
LoF Constraint
0.07LOEUF
pLI 1.000
Z-score 11.38
OE 0.03 (0.010.07)
Highly constrained

Among the most LoF-intolerant genes (~top 3%)

Missense Constraint
6.23Z-score
OE missense 0.61 (0.590.64)
1271 obs / 2067.9 exp
Constrained

Extremely missense-constrained (top ~0.01%)

Observed / Expected Ratios
LoF OE0.03 (0.010.07)
00.351.4
Missense OE0.61 (0.590.64)
00.61.4
Synonymous OE0.90
01.21.6
LoF obs/exp: 5 / 160.7Missense obs/exp: 1271 / 2067.9Syn Z: 2.24
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveKMT2A-related Wiedemann-Steiner syndromeLOFAD
DN
0.14100th %ile
GOF
0.14100th %ile
LOF
0.92top 5%

The highest-scoring mechanism for this gene is loss-of-function (haploinsufficiency).

LOFprediction above median · 1 literature citation · 81% of P/LP variants are LoF · LOEUF 0.07

Literature Evidence

LOFDe novo mutations in MLL cause Wiedemann-Steiner syndromePMID:22795537

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.

ClinVar Variant Classifications

400 submitted variants in ClinVar

Classification Summary

Pathogenic23
Likely Pathogenic4
VUS194
Likely Benign154
Conflicting3
23
Pathogenic
4
Likely Pathogenic
194
VUS
154
Likely Benign
3
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
22
0
1
0
23
Likely Pathogenic
0
4
0
0
4
VUS
4
177
13
0
194
Likely Benign
0
4
34
116
154
Benign
0
0
0
0
0
Conflicting
3
Total2618548116378

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

KMT2A · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Acute Myeloid Leukemia With t(9;11)(p22.3;q23.3); MLLT3-KMT2AFibroblast Growth Factor Basic Form MeasurementFLT3 Internal Tandem Duplication

Nintedanib and Azacitidine in Treating Participants With HOX Gene Overexpression Relapsed or Refractory Acute Myeloid Leukemia

ACTIVE NOT RECRUITING
NCT03513484Phase PHASE1Northwestern UniversityStarted 2018-11-14
AzacitidineLaboratory Biomarker AnalysisNintedanib
ALL, AdultAML, AdultAcute Leukaemia

A Study of BN104 in the Treatment of Acute Leukemia

ACTIVE NOT RECRUITING
NCT06052813Phase PHASE1, PHASE2Institut de Recherches Internationales Servier (I.R.I.S.)Started 2023-10-19
BN104 monotherapyBN104 monotherapyBN104 monotherapy - rp2d
Leukemia, Myeloid, Acute

A Study of Bleximenib, Venetoclax and Azacitidine For Treatment of Participants With Newly Diagnosed Acute Myeloid Leukemia (AML)

RECRUITING
NCT06852222Phase PHASE3Janssen Research & Development, LLCStarted 2025-06-04
BleximenibVenetoclax (VEN)Azacitidine (AZA)
Menin InhibitorsAcute LeukemiaPost Hematopoietic Stem Cell Transplantation

A Real-world Study on the Efficacy and Safety of Menin Inhibitors as Maintenance After Allo-HSCT

RECRUITING
NCT07559695The First Affiliated Hospital of Soochow UniversityStarted 2025-11-01
Acute Myeloid Leukemia With FLT3/ITD MutationAcute Myeloid Leukemia With KMT2A RearrangementAcute Myeloid Leukemia With NPM1 Mutation

SNDX-5613 and Gilteritinib for the Treatment of Relapsed or Refractory FLT3-Mutated Acute Myeloid Leukemia and Concurrent MLL-Rearrangement or NPM1 Mutation

RECRUITING
NCT06222580Phase PHASE1Uma BorateStarted 2024-02-20
Biospecimen CollectionBone Marrow Aspiration and BiopsyGilteritinib
AML, ChildhoodAcute Myeloid Leukemia

Clinical Study of Induction Therapy Options Based on Molecular Subtyping and MRD in Children and Adolescents With AML

RECRUITING
NCT06221683Phase PHASE2Children's Hospital of Soochow UniversityStarted 2024-01-01
HomoharringtonineCytarabineEtoposide
16P11.2 Deletion Syndrome16p11.2 Duplications1Q21.1 Deletion

Online Study of People Who Have Genetic Changes and Features of Autism: Simons Searchlight

RECRUITING
NCT01238250Simons SearchlightStarted 2010-10
Acute Myeloid Leukemias

A Study of SNDX-5613 in Combination With Intensive Chemotherapy in Participants With Acute Myeloid Leukemias

RECRUITING
NCT06226571Phase PHASE1Syndax PharmaceuticalsStarted 2024-05-21
SNDX-5613Chemotherapy RegimenHiDAC
Acute Myeloid Leukemia, Adult

Revumenib in Combination With Azacitidine + Venetoclax in Patients NPM1-mutated or KMT2A-rearranged AML

RECRUITING
NCT06652438Phase PHASE3Stichting Hemato-Oncologie voor Volwassenen NederlandStarted 2025-03-31
RevumenibPlacebo
Acute Lymphoblastic Leukemia, PediatricALL, Infants

Combined Immuno-chemotherapy for Patients With B-linear Acute Lymphoblastic Leukemia Diagnosed From 0 to 365 Days of Life (ALL-Baby-2021)

RECRUITING
NCT05029531Phase PHASE3Federal Research Institute of Pediatric Hematology, Oncology and ImmunologyStarted 2021-09-23
the risk-adapted choice of therapy and the use of a combination of chemotherapy with immunotherapy and hematopoietic stem cell transplantation for patients with risk factors.
Acute Myeloid LeukemiaAcute Lymphoblastic LeukemiaMixed Lineage Acute Leukemia

A Study of Revumenib in R/R Leukemias Including Those With an MLL/KMT2A Gene Rearrangement or NPM1 Mutation

RECRUITING
NCT04065399Phase PHASE1, PHASE2Syndax PharmaceuticalsStarted 2019-11-05
revumenibcobicistat
Acute Myeloid Leukemia

Ziftomenib for the Treatment of Patients With NPM1 Mutated or KMT2A Rearranged Acute Myeloid Leukemia Not Eligible for Standard Therapy

NOT YET RECRUITING
NCT06930352Phase PHASE2Uma BorateStarted 2026-04-10
Biospecimen CollectionBone Marrow AspirationBone Marrow Biopsy
Clinical Literature
Open Research Assistant →
Full-Text Mentions
NLP-detected gene mentions in article bodies · via PubTator3
PubTator3
KMT2A
Liu J et al.·Zhonghua Xue Ye Xue Za Zhi
2024
KMT2A::MAML2 1
Zhang Y et al.·Zhonghua Xue Ye Xue Za Zhi
2024
KMT2A::TBC1D5 T 1
Li YY et al.·Zhonghua Xue Ye Xue Za Zhi
2025
Top 5 full-text resultsSearch PubTator3 ↗
Key Publications
Landmark & review papers · by relevance
PubMed
Top 5 results · since 2015Search PubMed ↗