Hypodiploid ALL, regarded as a poor prognosis group, has been extensively evaluated in pediatric ALL:66 NGS proved that lesions involving receptor tyrosine kinases and RAS signaling (i.e. NRAS, KRAS, FLT3 and NF1) can be detected in up to 70% of near haploid cases, whereas low hypodiploid cases are characterized by lesions involving members of the Ikaros family, particularly IKZF2, and by TP53 disruptions, that can be identified in 91.2% of these cases. This evidence concerns the gene NRAS and acute lymphoblastic leukemia.