The finding of MEF2D rearrangements as a hallmark of a subtype of ALL with a distinct gene expression profile provides another example of ALL subtypes that are cryptic (in this case, due to the common involvement of rearrangement of two genes co-located on one chromosome) and represented by rearrangement to diverse partners rather than a single fusion observed in other subtypes of ALL. The gene discussed is MEF2D; the disease is acute lymphoblastic leukemia.