Finally, it is important to note that in the one single case progressed toward MDS after 32 years of follow-up, mutations of predicted pathogenic significance were found by NGS for ASXL1 and KIT genes, whereas the BM morphology, alongside with the classical ET thrombocytopoiesis, displayed also features of hypercellularity and left-shifted erythropoiesis and presence of megakaryocytes with maturation defects. This evidence concerns the gene KIT and myelodysplastic syndrome.