Optimal clinical care of these patients, however, does rely on identifying these underlying mutations; DDX41-related donor-derived leukemia has been described in several individuals with MDS/AML who underwent hematopoietic stem cell transplantation (HSCT) from matched related donors (MRD) found later to carry the familial DDX41 mutation (11, 12). This evidence concerns the gene DDX41 and myelodysplastic syndrome.