In this study, we collect 5 BM samples from newly diagnosed AML patients with RUNX1::RUNX1T1, one of the most common genetic abnormalities in core-binding factor AML [15, 16], as examples for paired scRNA-seq and scV(D)J-seq. We trace the differentiation trajectory of tumor-reactive T cells and reveal that the AML tumor-reactive T cell shows a non-exhausted senescent-like cytotoxic T cell profile with upregulated NK-related markers. Here, RUNX1T1 is linked to acute myeloid leukemia.