the deletion of long arm of chromosome 5 ( del(5)(q32 ) ) is a very rare event in acute lymphoblastic leukemia ( all ) and has not been analyzed extensively . the del ( 5)(q ) is associated with 20 - 30% of mds , either as the sole identifiable abnormality , or in combination with one or more additional abnormalities.[14 ] although , this particular abnormality is common to myeloid lineage associated neoplasias , nevertheless , we present a case of t - all with del(5)(q32 ) as a sole chromosomal abnormality with case history and discussed with relevant literature . a 75-year - old male patient presented to the opd of bangalore institute of oncology with a one month history of intermittent fever and loss of appetite . there was no history of bleeding tendency , diabetes mellitus , hypertension and ihd . on physical examination , his abdomen , complete blood count showed hb12.5g / dl , wbc 130.46  10/l , neutrophils 2% , lymphocytes 20% , blasts 78% , rbc 4.33  10/l , platelet count 127  10/l and ldh was high with an activity of 1949u / l . immunophenotyping performed on bone marrow aspirate with a gating on ssc / fsc showed majority of the gated cells to be strongly expressing cd45 , cd5 , cd10 , cd7 , ccd3 , cd34 , and cd13 and weakly positive or negative for cd14 , cd33 , cd19 , cd3 , hla - dr , cd117 , cd8 , cd22 , cd4 , ccd22 , mpo and tdt . the scattered parameters and antigen profile as analyzed by flow cytometry ( cyan - dako ) correlated with morphology and diagnosis of t - acute lymphoblastic leukemia ( calla + ve ) the bone marrow aspirate was cultured for direct and 24hrs in rpmi-1640 medium supplemented with 20% qualified ; heat inactivated fetal bovine serum , 100 u / ml penicillin and streptomycin , without any mitogen at 37c . the cultures were exposed to colcemid ( final concentration- 0.1 g / ml ) for 30 minutes followed by hypotonic treatment ( 0.075 m kcl ) for 20 minutes at 37c and fixed in methanol : glacial acetic acid ( 3:1 ) overnight at 4c . later , air dry slides were made and incubated at 60c overnight for aging . a total of 25 metaphases were screened , captured , karyotyped and analyzed using applied spectral imaging software ( asi ) . all 25 metaphases consistently showed a karyotype of 46 , xy , del(5)(q32 ) [ figure 1 ] . del(5)(q32 ) is a most frequent and documented recurrent chromosome abnormality with favourable prognosis in mds.[13468 ] this is also reported in acute myeloid leukemia ( aml ) transformed from mds ( 1 ) . the rarity of ( 5)(q ) deletion in all and the same abnormality in our patient persuaded us to explore the literature . 1992 ) have reported three cases : del(5)(q ) in all with biphenotypic and early progenitor phenotype as sole abnormality in the first case , as an evolutionary event in another and with ph positivity in a third case . in contrast to its presence in aml , del(5 ) ( q ) in all is not an adverse prognostic indicator , and it appears to be more frequent in children . our patient is an adult and has been diagnosed as having t - all by flow cytometry and all - l2 by morphology . the patient is undergoing treatment and will be followed up to evaluate the prognostic significance of del(5)(q ) . literature review reveals , that del(5)(q ) is also reported in chronic lymphocytic leukemia ( cll ) . however , they are rare and been reported only as karyotypic results without known prognosis . ( 2010 ) describe two cll cases with del(5)(q ) not associated with adverse prognosis and not related to induced chromosome changes . this abnormality is not only reported in leukemia but also reported in small cell neuroendocrine lung carcinoma . these are difficult to estimate by conventional cytogenetic analysis , because small differences in base pairs at deletions are beyond the sensitivity of the technique . further studies are required to elucidate the prognostic value of del(5)(q ) in more all patients and to identify candidate genes that may play a vital role in the pathogenesis of all .