T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive cancer with resistant clonal propagation in recurrence. We performed high-throughput droplet-based 5'-single-cell RNA with paired T-cell receptor (scTCR) sequencing of paired diagnosis-relapse (Dx_Rel) T-ALL samples to dissect the clonal diversities. Two leukemic evolutionary patterns, “clonal shift” and “clonal drift” were unveiled. Targeted single-cell DNA sequencing of paired Dx_Rel T-ALL samples further corroborated the …