Since all of the DNMT3A mutations detected in the current MPAL samples were non-R882 mutations (Supplementary Table 2) and were clonal in bone marrow (median estimated CCF = 1.0), we suspected that some MPAL cases are outgrowths of pre-leukemic clonal hematopoiesis, as clonal hematopoiesis is often associated with this type of DNMT3A mutations7,8. Here, DNMT3A is linked to mixed phenotype acute leukemia.