Cytogenetic and molecular studies identified a BCR-ABL1 [t(9;22)] gene rearrangement in 10% of cells by fluorescence in situ hybridization (FISH) analysis, with negative results for promyelocytic leukemia/retinoic acid receptor alpha (PML-RARA), core binding factor subunit beta (CBFB), lysine methyltransferase 2A (KMT2A) (MLL), and RUNX1T1/RUNX1. Cytogenetic analysis was inconclusive due to insufficient metaphases, and next-generation sequencing (NGS) (Tempus, Chicago, IL) did not identify significant pathogenic mutations in addition to the actionable mutation in BCR-ABL1. Here, KMT2A is linked to acute promyelocytic leukemia.