Hyperdiploidy which is referred to >50 chromosomes, has shown to contribute to a better prognosis in children with ALL.[29] However, a significantly lower prevalence of hyperdiploidy was observed in ALL children with DS which might contribute to the poorer post therapeutic outcomes when compared to children without DS.[24] In addition, TEL-AML1 rearrangement is a genetic abnormality which is most frequent in children with ALL. Here, ETV6 is linked to acute lymphoblastic leukemia.