This study reports an adult AML-M4 patient with atypical chromosomal aberrations present in all dividing bone marrow cell at diagnosis: t(1;8)(p32.1;q24.2), der(9)t(9;10)(q22;?), and ins(19;9)(p13.3;q22q34) that may have originated transcripts with leukemogenic potential. Acute non-lymphocytic or myelogenous leukemia (ANLL or AML) represents a hematopoietic malignancy characterized by abnormal cell proliferation and stalled differentiation leading to the accumulation of immature cells in the marrow itself, in peripheral blood and eventually in other tissues. Primary chromosomal abnormalities in AML are highly specific and considered to be associated with leukemic transformation, whereas secondary changes are less specific and probably contribute to disease progression. As reviewed by Chen and Sandberg. (2002), the common chromosomal abnormalities in the acute myelomonocytic leukemia FAB (French-American-British Cooperative Group) type M4 include monosomy 5 or del(5q), monosomy 7 or del(7q), trisomy 8, t(6;9) (p23;q34), and rearrangements involving the Mixed Lineage Leukemia (MLL) gene mapped at 11q23 [del(11) (q23); t(9;11)(p22;q23), t(11;19)(q23;p13)], and Core Binding Factor B (CBFβ) mapped at 16q22 [del(16)(q22), inv(16)(p13q22), t(16;16)(p13;q22)]. Less frequently, trisomy 4, trisomy 22, t(8;21)(q22;q22) and rearrangements with breakpoints in 3q21, 3q26, 8p11, 11p15 and 11q13 have also been reported in FAB M4 type patients