Leukemia is the most common childhood cancer, accounting for more deaths due to disease in developed nations than any other illness. 1 While leukemias can occur at any age, the mutations that cause childhood leukemias often differ from those that cause adult leukemias. 2 Some types of leukemia, such as juvenile myelomonocytic leukemia, present almost exclusively in early childhood. 3 These observations suggest that for several leukemogenic mutations, transformation efficiency changes with age. Alternatively, age-restricted leukemias might arise from cells of origin that emerge, and then disappear, through the course of normal ontogeny. In either case, transcriptional programs that direct normal ontogeny of the immune system can substantially influence leukemogenesis.