A study involving patients with early T cell precursor (ETP)-ALL reported one subset with unique biology that might represent a provisional entity with a characteristic immunophenotypic and genetic profile (myeloid-associated gene mutations, such as mutations in DNMT3A, ETV6, FLT3, GATA3, IDH1, IDH2, JAK3, NRAS/KRAS, and RUNX1); the prognostic significance of the profile remains debated10–12. This evidence concerns the gene NRAS and acute lymphoblastic leukemia.