Considering that SBS18 has been associated with DNA damage caused by reactive oxygen species (ROS) (https://cancer.sanger.ac.uk/signatures/sbs/sbs18/) and that the RUNX1::RUNX1T1 chimeric protein is known to downregulate the expression of the OGG1 gene encoding a DNA glycosylase that excises oxidized guanines [6], we hypothesized that ROS could be involved in the genesis of childhood AML with RUNX1::RUNX1T1 [3]. This evidence concerns the gene RUNX1 and acute myeloid leukemia.