High-risk features of pediatric ALL include KMT2A (MLL) translocations, t(9;22)/BCR/ABL1, t(17;19)/TCF3-HLF, near haploidy and low haploidy, t(1;19)/TCF3-PBX1, intrachromosomal amplification of chromosome 21 (iAMP21), immunoglobulin heavy chains (IGH) translocations, Ikaros (IKZF1) gene deletions (a hallmark of pediatric high-risk ALL), and IKZF1plus (deletion without the ERG deletion but accompanied by other gene deletions such as CDKN2A/2B, PAX5, and PAR1) [5,10,11]. The gene discussed is TCF3; the disease is acute lymphoblastic leukemia.