HLF and acute lymphoblastic leukemia: In B-cell ALL (B-ALL), these high-risk genomic features include hypodiploidy (<40 chromosomes), the intrachromosomal amplification of chromosome 21 (iAMP21), and translocations such as TCF3::HLF, BCR::ABL1 (Philadelphia chromosome-positive (Ph+)), those involving KMT2A, and those associated with Philadelphia-like (Ph-like) ALL [3,4].