Although ELN 2017 recommendation indicates that adult patients with concurrent mutant NPM1 and FLT3-ITD of low allelic ratio (<0.5) have favorable outcome (1), another study suggests that these patients have inferior survival compared to other favorable-risk AML patients, and concurrent DNMT3A mutation may serve as a risk modifier (5). Here, FLT3 is linked to acute myeloid leukemia.