To enhance the therapeutic options for the patient, a genomic analysis was performed and a molecular tumor board report was filed, noting a microsatellite instability of only 0.8%, an ATRX (alpha thalassemia/mental retardation syndrome X-linked) frameshift mutation, MYCL and RICTOR (Rapamycin-insensitive companion of mTOR) amplification and KDM6A (Lysine-specific demethylase 6 A) biallelic loss. The gene discussed is ATRX; the disease is Alpha-thalassemia.