Mutations in ASXL1 seem to be associated with an aggressive phenotype in all myeloid malignancies [8]: they are frequent in high-risk MDSs and correlate with poor prognosis in MDSs [118-120] and with acute progression in CMML [36], they are more frequent in myelofibrosis than in other MPNs [37,121], and characterize secondary AML. The gene discussed is ASXL1; the disease is acute myeloid leukemia.