NRAS and Splenomegaly: Khanna and collaborators reported an aCML case with NRAS G12V mutation who experienced a notable response to trametinib with improvement in blood counts and 14 months of disease control (186), while another patient carrying NRAS G12D mutation treated with trametinib obtained a hematological response with blood cell count normalization and reduction of splenomegaly for 3 months (14).