A 70 years old with newly de novo acute myelomonocytic leukemia (AML). G-band karyotyping shows the presence of deletion 5q and a ring (r) of chromosome 11 with a homogeneously staining region (hsr) (Figure 1) in all metaphases. Fluorescence in situ hybridization (Figure 2) using KMT2A probe Dual Color, break apart (Metasystems, Germany) shows KMT2A amplification. Metaphase FISH confirmed the KMT2A amplification in the ring chromosome (Figure 3).\nIntrachromosomal regions are hallmarks of genetic amplification in cancer. Ring chromosomes are also vehicles of genes amplification. Although they are often found in solid neoplasm, they are rare in leukemia, been detected in less than 1% of AML with abnormal karyotype and mostly associated with AML with myelodysplastic-related changes and therapy-related AML, older age, complex karyotype and poor prognosis. They could also be detected in myelodysplastic syndromes, chronic myelomonocytic leukemia and chronic myeloid leukemia in blast-phase at diagnosis or during the course of the disease.