Higher clonal dynamics correlate with shorter event-free survival. Pre–B-cell cALL cases were divided into groups of low and high clonal dynamics based on the median dynamic mutation rate value. A Kaplan-Meier curve estimating the relapse probability over time was constructed for each group. Solid and dashed lines stand for clonal dynamics over and under the median value, respectively. Cases with higher clonal dynamics had significantly shorter event-free survival (P = .0067, χ² test).