This emerged as a strong correlation in our MRD positive cases which predominantly showed gain of copies of several genes including LEF1, RUNX1, PAR1, NR3C2, PHF6, and CASP8AP2. Over-expression of LEF1 has been reported to predict unfavorable outcome and the standard-risk B-ALL patients with high LEF1 expression can possibly benefit from early treatment modifications and alternative molecular therapies, such as agents targeting the Wnt signaling pathway (35). This evidence concerns the gene CASP8AP2 and precursor B-cell acute lymphoblastic leukemia.