While the human NOTCH1 gene initially was cloned as part of a translocation breakpoint in T cell acute lymphoblastic leukemia (T-ALL) tumors, this translocation is present in only a small percentage of T-ALL patients. A recent paper by Weng et al. (2004) demonstrates that novel types of activating mutations in the NOTCH1 gene occur in more than half of all T-ALL cases, implicating NOTCH1 as a major player in the etiology of T-ALL.