RUNX1 mutations occur in 13.7% of normal chromosome karyotype AML patients but rarely in APL patients.[1, 3] In AML patients, the RUNX1 mutation is correlated with poor clinical outcomes, even when treatment with intensive therapeutic strategies is performed.[12] Our patient showed resistance to the standard 3 + 7 induction chemotherapy but benefitted from a homoharringtonine (HHT)-based combination. Here, RUNX1 is linked to acute promyelocytic leukemia.