Similarly, EVs derived from patients with pediatric ALL (pALL) contain miR-181a, which upregulates several proliferation and survival genes, such as proliferating cell nuclear antigen (PCNA), Ki-67, myeloid cell leukemia-1 (MCL-1), and B-cell lymphoma 2 (BCL2). This evidence concerns the gene MCL1 and acute lymphoblastic leukemia.