The risk of MDS with subsequent AML depends on the cumulative dose of alkylating agents, while epipodophyllotoxins and other topo II i induce leukemias with MLL gene translocations at chromosome bands 11q23, t(8;21), t(3;21), inv(16), t(8;16), t(15;17), or t(9;22) [47,56,57]. The gene discussed is KMT2A; the disease is acute myeloid leukemia.