Major criteriaMegakaryocytic proliferation and atypia, without reticulin fibrosis >grade 1, accompanied by increased age-adjusted BM cellularity, granulocytic proliferation, and often decreased erythropoiesisNot meeting the WHO criteria for BCR-ABL1-positive CML, PV, ET, myelodysplastic syndromes, or other myeloid neoplasms Presence of JAK2, CALR, or MPL mutation or in the absence of these mutations, presence of another clonal marker, or absence of minor reactive BM reticulin fibrosis. This evidence concerns the gene CALR and myelodysplastic syndrome.