In all three cohorts, highly methylated status corresponding to the bi-allelic methylation was most frequently observed in BCP-ALL with favourable karyotypes such as high-hyperdiploid and ETV6::RUNX1, whereas it was rarely observed in BCP-ALL with unfavourable karyotypes such as MLL rearrangement and BCR::ABL1 [17]. Here, RUNX1 is linked to acute lymphoblastic leukemia.