We found no driver mutations in TET2, DNMT3A, PPM1D, IDH1, IDH2, TP53, CHEK2, ASXL1, MBD4 or other genes associated with myelodysplasia or AML, and the patient has reported no haematological problems in over two decades of follow-up. The gene discussed is PPM1D; the disease is acute myeloid leukemia.