Zebisch and coworkers described a family in which a 60-year-old female affected with MDS was transplanted from her 58-year-old apparently healthy sister; the graft function was poor, and laboratory investigations demonstrated the presence of the same ASXL1 mutation, p.Pro808His, in the donor sister (Zebisch et al., 2020). The gene discussed is ASXL1; the disease is myelodysplastic syndrome.