This finding is consistent with our previous findings in pediatric B-ALL (18) and are further supported by literatures performed by Abbal et al. and Konantz et al., in which a significant downregulation of EVI1 gene expression were also found in adult Ph-negative ALL patients with the KMT2A::AFF1+/ t(4;11) rearrangement (14, 17). Here, MECOM is linked to precursor B-cell acute lymphoblastic leukemia.