The use of risk-directed chemotherapy for childhood acute lymphoblastic leu- kemia (ALL) has improved the success of therapy dramatically in the last 40 years; however, a substantial proportion of patients experience relapse and many of these have no known risk factors. There- fore, more accurate risk classification of newly diagnosed disease is needed to reduce relapses and improve the overall outcome. This study by Yang et al. aimed at agnostically testing, with a genome- wide approach, genotypes at 444,044 SNPs for their association with the risk of relapse in 2535 children with newly diagnosed ALL, the largest group of chil- dren with cancer ever studied for genetic determinants of outcome [1]. Germline DNA was collected at remission in chil- dren with ALL treated according to St Jude Children’s Research Hospital (TN, USA) Total XIIIB and XV protocols and the Children’s Oncology Group (COG) P9906 or P9904/9905 studies [2]. Relapse was defined as disease recurrence in bone marrow and/or extramedullary sites.
