Recently, in a cohort of 407 patients from the National Institutes of Health, the presence of specific somatic mutations was found to be predictive of evolution to MDS/AML when detected at 6 months after IST; including RUNX1, splicing factor mutations, and ASXL1.[9] By contrast, the predictive value of isolated mutations in genes like TET2 and DNMT3A, which are frequently mutated in age-related clonal hematopoiesis was lower, these genes require additional genetic events to give rise to a myeloid neoplasm. The gene discussed is RUNX1; the disease is acute myeloid leukemia.