Among all investigated genetic alterations, we identified mutations in five different genes (ASXL1 present in 3/19 progressed/transformed cases, DNMT3A in 2/19, NRAS in 2/19, SRSF2 in 4/19 and TP53 in 4/19, and being cumulatively present in 10/19 progressed/transformed cases) that strongly correlated with disease progression or/and transformation into AML, even if only one of these genes was mutated, since these mutations were not observable in the 11 cases that remained stable (p = 0.003). Here, NRAS is linked to acute myeloid leukemia.