Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome (MDS)/myeloproliferative disorder most commonly seen in the elderly. We describe an adolescent with monosomy 7 CMML presenting as central diabetes insipidus (DI), who was treated with venetoclax and decitabine as a bridge to hematopoietic stem cell transplantation (HSCT). Central DI is a rare manifestation of monosomy 7-associated MDS including CMML, itself a rare manifestation of GATA2 deficiency, particularly in children. Venetoclax/decitabine was effective for treatment of CMML as a bridge to HSCT. Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome (MDS)/myeloproliferative disorder most commonly seen in the elderly. 1,2 We describe an adolescent with GATA2 associated monosomy 7 CMML presenting as central diabetes insipidus (DI), who was Abbreviations: AML, acute myelogenous leukemia; CMML, chronic myelomonocytic leukemia; DDAVP, desmopressin; DI, diabetes insipidus; HSCT, hematopoietic stem cell transplantation; MDS, myelodysplastic syndrome; MRI, magnetic resonance imaging successfully treated with venetoclax and decitabine as a bridge to hematopoietic stem cell transplantation (HSCT). A 15-year-old adolescent male presented to the National Institutes of Health (NIH) for initial evaluation of GATA2 deficiency on the Natural History of GATA2 Deficiency Study (Clinicaltrials.gov NCT01905826) based on his mother and aunt's known diagnoses of GATA2 deficiency. His mother was successfully transplanted for MDS from a partially matched sibling 15 years earlier. Previous sequencing