These patients have lower survival rates and higher risk of progression to acute myeloid leukemia (AML).(1)Genetic markers are determinant of outcomes in patients with MF and have been incorporated into formal prognostic systems, such as MIPSS70+ and GIPSS.(1)Other risk factors which contribute to progression to AML include unfavorable karyotypes, circulating blast percentages higher than 3%, platelet counts less than 50,000, TP53, and high-risk somatic mutations such as ASXL1 (frequency of 22%), SRSF2 (9%), EZH2 (5%), IDH1/2 (3%) and U2AF1 Q157 (16%).(1). Here, ASXL1 is linked to acute myeloid leukemia.