In our case, ASXL1 mutation (along with thrombocytopenia) was detected with PRKDC and MYOM2 mutations without the sequencing panel at preliminary diagnosis at low levels, and VAF of CSF3RT618I, SETBP1, and SRSF2 increased at progression to AML transformation. This evidence concerns the gene ASXL1 and acute myeloid leukemia.