 We report an extremely rare case of acute myelomonocytic leukemia (M4) with an MLL-ELL fusion gene lacking the PML-RAR? rearrangement that transformed from hypergranular acute promyelocytic leukemia (APL) without showing any karyotypic evolution.     ///    MLL-ELL fusion gene in an acute myelomonocytic leukemia patient transformed from acute promyelocytic leukemia.. 