Four of 6 cases with > 5 SNV + Indel/Mb and germline variations in MLH1, MSH2, MSH6, PMS2, POLE or POLD1 belonged to Myeloid Predominant, suggesting higher levels of immune infiltration in patients with biallelic Mismatch Repair Deficiency (bMMRD) syndrome. The gene discussed is POLD1; the disease is mismatch repair cancer syndrome 1.