In addition, considering the sequential acquisition of DDX41 mutations observed in myeloid malignancies, hematopoietic cells with a heterozygous germline DDX41 variant would have to wait until they acquire somatic mutations in other alleles to develop a myeloid malignancy, because DNA replication stress acquired in cells with a heterozygous variant may be limited even in aged HSCs. The gene discussed is DDX41; the disease is myeloid neoplasm.