Fernandez-Mercado et al. have explored the mutation patterns in a group of 33 secondary AMLs with normal karyotype (24 secondary to MDS and nine to CMML) and showed that in s-AMLs developed following a previous MDS, 13% of cases displayed IDH1 mutations and 8.7% IDH2 mutations; in these patients, frequent were the ASXL1 mutations (41.7%), whereas NPM1 mutations occurred in 12.5% of cases [61]. Here, ASXL1 is linked to myelodysplastic syndrome.