This epigenetic alteration, characterized by DNA methylation, shown in Figure 3, is associated with KLF4 downregulation and gene silencing as observed in pediatric patients with T-cell acute lymphoblastic leukemia (T-ALL), where the loss of KLF4 significantly promotes NOTCH1-driven T-ALL development (132). This evidence concerns the gene NOTCH1 and acute lymphoblastic leukemia.