In a recent Letter to the Editor published in Annals of Hematology, researchers from the University of Freiburg, Germany, reported on a case study of a patient diagnosed with high-risk multiple myeloma who developed therapy-related acute myeloid leukemia (AML). Treatment of AML consisted of decitabine/venetoclax, and daratumumab was given to treat progressive multiple myeloma. Monika Engelhardt, MD, PhD, of the University of Freiburg, and colleagues hypothesized that “upregulation of CD38 in bone marrow plasma cells after decitabine/venetoclax may have enhanced [the] multiple myeloma response.”