NRAS and myeloproliferative neoplasm: Signal pathway mutations are common in CMML and include: JAK2V617F (~10–15%), RAS (KRAS and NRAS ~20–30%), and CBL (~10–20%) mutations.7, 75RAS (KRAS—-Kirsten Rat Sarcoma viral oncogene homolog—chromosome 12p12.1 and NRAS—Neuroblastoma RAS viral oncogene homolog—chromosome 1p13.2) mutations are often associated with a MPN-like CMML phenotype.76 Although univariate analysis studies with RAS mutations have demonstrated inferior outcomes, these findings have not been substantiated in multivariable models.7, 8