In addition to having a lower frequency of good prognostic molecular subtypes including ETV6::RUNX1 fusion gene and high hyperdiploidy, childhood ALL patients with more Indigenous American ancestry had a higher frequency of the poor prognosis molecular subtypes, such as CRLF2 rearrangements and Philadelphia chromosome-like (Ph-like) ALL (50). The gene discussed is RUNX1; the disease is acute lymphoblastic leukemia.