Acute lymphocytic leukemia (ALL) is a fatal disease in 70% of adults and in most children who either relapse or do not go into initial remission. New therapeutic approaches are needed. We (Maya Koren-Michowitz/Koeffler) have spent a large amount of our academic careers treating these patients and looking for genomic abnormalities in their cells that might help us improve their therapies.Recently, we have utilized several new technologies called exon sequencing and distant pair-end whole genome sequencing (or gPET), as well as a second complementary technique, exon capture and DNA sequencing. Using these techniques, we will look at a selected group of ALL samples at diagnosis, remission and relapse to understand the full scope of genomic changes that occur in ALL. With that knowledge, we will interrogate a very large number of ALL samples to determine the clinical frequency and clinical significance of these alterations. Finally, we will use this knowledge to identify new therapeutic targets, and work with various industrial and academic entities to develop novel therapies, both for adult and pediatric ALL.