This potent activity of asparaginase in hematopoietic neoplasms has led to its integral role in the first-line standard of care for lymphoblastic leukemias.1–4 Dose intensification of asparaginase has led to improved outcomes in T cell and B cell acute lymphoblastic leukemias1,5–7; however, resistance to asparaginase-based therapies is associated with poor prognosis, and effective treatment options remain limited for many of these patients.8 The gene discussed is ASPG; the disease is acute lymphoblastic leukemia.