Related to CHIP defined by the occurrence of mutations at the TET2, DNMT3A, or ASXL1 genes, we observed that this event was present in the first mutant clone in 46.15% (6/13) of the studied MDS cases without any association with the clinical response to HMA (Fisher exact test, P > 0.05; Fig. 2D). This evidence concerns the gene ASXL1 and myelodysplastic syndrome.