Gene mutations in epigenetic regulators (ASXL1, TET2, DNMT3A and EZH2) and RNA splicing (U2AF1 and SRSF2) were considered as the additional subclonal mutations and cooperated with the MPN driver mutation (JAK2, MPL or CALR) to play a key role in the pathogenesis of primary myelofibrosis [25,26,27]. This evidence concerns the gene CALR and primary myelofibrosis.