Concurrent intracranial hemorrhage and spontaneous tumor Lysis syndrome as the initial presentation of KMT2A::AFF1-rearranged adult ALL: a case report

Background: -rearranged ALL is a high-risk subtype with an aggressive course. However, the simultaneous occurrence of catastrophic intracranial hemorrhage (ICH) and spontaneous tumor lysis syndrome (TLS) as the initial presentation is rare in adult patients and remains poorly characterized in the literature. Case Presentation: fusion gene. Conclusion: -rearranged ALL, characterized by the concurrent development of ICH and spontaneous TLS prior to the initiation of any leukemia-specific therapy. It underscores the critical importance of promptly recognizing this hyperacute syndrome in young patients presenting with unexplained neurological symptoms and profound hematologic abnormalities. Early multidisciplinary management and awareness of high-risk genetic profiles are essential, although the prognosis in such scenarios remains exceedingly poor.