As the breakpoint occurs after exon 1, it is likely that ectopic expression of HOTTIP is caused by promoter activity of MIR181A1HG. In general, a dysregulated HOXA13 expression has been connected to underlying HOXA13 fusions resulting in altered 3D chromatin configuration as contributing factor to T-ALL leukemogenesis [41]. The gene discussed is HOTTIP; the disease is acute lymphoblastic leukemia.