Furthermore, adult ALL cases have a poor prognosis,[45] with a relapse rate of 40.0% compared to 9.6% in pediatrics.[46] Treating ALL remains challenging due to the high risk of relapse shortly after complete remission,[46] which often results in refractory leukemia that is difficult to cure, with a 5-year overall survival rate of approximately 50%.[45] This review will focus on the implications of PAX5 mutations in ALL development, particularly B-ALL. The gene discussed is PAX5; the disease is leukemia.