NPM1 and Melnick-Needles syndrome: However, based on five NPM1-mutated MNs cases who did not receive any upfront therapy and subsequently experienced early AML progression after a median observation of three months, the authors inferred that the upfront HMA treatment received by the majority of NPM1-mutated MNs cases could have favorably altered the clinical course of the underlying myeloid malignancy, therefore delaying a potentially more rapid AML transformation.