Impact of KIT mutations on prognosis in pediatric acute myeloid leukemia with RUNX1::RUNX1T1 fusion: a systematic review and meta-analysis

Background The prognostic impact of KIT mutations in pediatric acute myeloid leukemia (AML) with RUNX1::RUNX1T1 remains controversial. Methods We conducted a systematic literature search of PubMed, Embase, Cochrane Library, Web of Science Core Collection, and China National Knowledge Infrastructure (CNKI) databases from their inception to November 26, 2025. Two investigators independently performed the literature search and study selection using predefined keywords. Eligible studies were screened according to inclusion and exclusion criteria, followed by data extraction. A meta-analysis was performed using R software. Results A total of 9 studies comprising 2103 patients were included in the final meta-analysis. The results demonstrated that KIT mutations were associated with inferior event-free survival (EFS) in pediatric AML patients with RUNX1::RUNX1T1 (HR = 2.69, 95% CI: 1.44–5.01), as well as inferior overall survival (OS) (HR = 3.06, 95% CI: 1.64–5.69). Conclusion In conclusion, KIT mutations are an adverse prognostic factor in pediatric acute myeloid leukemia with RUNX1::RUNX1T1 . Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251243028.