Thirty‐two patients (52.5%) presented as secondary/concomitant MS as follows: Eight following AML (2 relapsed after allo‐HSCT), one following T lymphoblastic lymphoma, one following the blastic phase of CML (occurred after allo‐HSCT, concomitant diffuse large B cell lymphoma, and oral squamous cell carcinoma), 19 with concomitant AML (1 case with normal bone marrow morphology but NPM‐MLF1 fusion gene‐positive that soon progressed to leukemia), one with CML, one with MDS, and one with primary myelofibrosis. The gene discussed is MLF1; the disease is leukemia.