However, the presence of myelodysplasia-related mutations resulted in worsening treatment outcome of NPM1-mutated/FLT3-ITD-negative patients, who had lower CR rates (67% vs 81%, P = 0.02), and shorter DFS (5-year rates, 30% vs 43%, P = 0.03) and OS (5-year rates, 32% vs 42%, P = 0.005) than NPM1-mutated/FLT3-ITD-negative patients without myelodysplasia-associated mutations (Fig. 4e, f, Supplementary Table 10). Here, NPM1 is linked to Myelodysplasia.