Thirty-nine of 198 (19.7%) patients had a VUS in DNA repair pathway genes (ATM, BLM, NBN, MLH1, MSH2, MSH6, ERCC4, FANCA/E/F/G/I/L, BRCA1, BRCA2, RAD51C, RFWD3, SLX4), 16/198 (8.1%) patients had a VUS in genes associated with bone marrow failure (RPL5, RPS10, RPS19, CTC1, DKC1, NHP2, PARN, RTEL1, TERT, SBDS), 12/198 (6.1%) patients had a VUS in the RAS pathway (CBL, NF1, A2ML1, MAP2K2, PTPN11, RAF1, RRAS, SHOC2), and nine of 198 (4.5%) patients had a VUS in genes associated with familial leukemia (ETV6, GATA2, IKZF1, RUNX1, PAX5). The gene discussed is RRAS; the disease is Bone marrow hypocellularity.