 Though MRD has greatly contributed to the substantial increase in ALL patients survival and outcome, nearly 15 to 20 of young ALL patients eventually succumb to relapse, resulting in relapsed ALL as being the 4th most common childhood malignancy Locatelli et al., 2012, Pui et al., 2012, Hunger and Mullighaan, 2015. Once relapse occurs only 30 to 50 of relapsed patients can be cured even with intensive chemotherapy and bone marrow transplantation Nguyen et al. 2008 and Locatelli et al., 2012. Relapsed ALL patients with high MRD prior to hematopoietic stem cell transplantation HSCT have a significantly worse probability of disease-free survival 10 years after relapse treatment begins Eckert et al., 2015. Therefore, it stands to reason that early detection of relapse before a large increase in MRD can improve relapse patients disease-free survival. Yet, many oncology groups dont incorporate monitoring in ALL treatment protocols because of the labor intensity of MRD measurement; and the invalidation of the feasibility of routine MRD monitoring. This is due to factors such as variable kinetics of leukemic cell regrowth van Dongen et al., 2015, and that nearly 50 of ALL patients succumb to relapse from a new leukemia clone not identified at diagnosis Choi et al., 2007. The frequency of monitoring may also be limited, especially in children, due to discomfort and practical difficulties posed by BM aspiration Coustan-Smith E. et al., 2002. A simple predictive test for ALL in blood would increase the practicality of testing ALL patients more frequently and may eventually lead to prevention of relapse by means of preemptive treatment. 