ASXL1 and obesity due to melanocortin 4 receptor deficiency: Apart from smoking, the aging population and obesity are significant risk factors contributing to the development of AML, with a marked increase in risk associated with higher BMI levels, especially class II and III obesity.39 Genetic alterations (TET2, JAK2, and ASXL1) have been linked to age-related clonal hematopoiesis, a condition commonly found in healthy individuals that becomes more prevalent with advancing age and is considered a precursor to AML.1,40 Studies have also indicated a connection between AML development in individuals aged 60 and older and a history of smoking.