Nevertheless, there is evidence that a considerable proportion of adult early immature T-ALLs, not fulfilling the immunophenotypic criteria for ETP-ALL, shows mutations in myeloid related oncogenes and tumour suppressor genes (such as IDH1, IDH2, DNMT3A, FLT3, ETV6 and NRAS), while exhibiting a lower prevalence of typical T-ALL genetic alterations (such as mutations in the NOTCH1 and FBXW7 genes). This evidence concerns the gene NOTCH1 and acute lymphoblastic leukemia.