In agreement, Makishima et al. demonstrated that mutational diversity (reflected by the Shannon index) was higher in secondary AMLs than HR-MDS, and secondary AMLs were enriched with mutations affecting FLT3, NPM1, NRAS, PTPN11, WT1, IDH1 and IDH2 genes (35). Here, FLT3 is linked to myelodysplastic syndrome.