After chemotherapy for AITL, the patient developed new cytopenias, due to a therapy-related myeloid neoplasm (MDS with excess blasts—2, WHO4R-2017), with the same TET2 and DNMT3A mutations previously identified, and with the acquisition of additional abnormalities in RUNX1 p.D198N and CEBPA p.H260N. The gene discussed is DNMT3A; the disease is myelodysplastic syndrome.