These could be a feature of the analysed group consisting of young MPN patients, as in a recent study, it was reported that adolescents and young adults with PV and PMF displayed significantly lower JAK2 V617F allele burdens compared to older patients having a similar disease phenotype.25 Accordingly, Dkk‐1 levels in plasma were not correlated with the mutated allele load suggesting that they might reflect early changes in bone marrow microenvironment rather than a direct relation with clonal burden. The gene discussed is DKK1; the disease is acquired polycythemia vera.