When we compared mutated genes in a historical cohort of 1693 healthy CH individuals including 12 MDS patients who derived from CH to dominant mutations in our MDS patients (Fig. 5a, b; Supplementary Figs. 18, 19 and Supplementary Table 5), mutations in DNMT3A, TET2, ASXL1, and JAK2 were more frequent in CH than in MDS (e.g., DNMT3A; 52 vs. 8%, P < 0.001; Fig. 5c; Supplementary Table 6). Here, DNMT3A is linked to myelodysplastic syndrome.