The use of thrombopoietin receptor agonists has not been approved for CMML patients with severe thrombocytopenia so far and as a consequence treatment with either azacitidine or hydroxyurea might be initiated earlier in comparison to patients who present with symptomatic anaemia, who also have erythropoiesis-stimulating agents as a therapeutic option. The gene discussed is MPL; the disease is chronic myelomonocytic leukemia.