With the presence of CH in the PBSC product being an independent risk factor of t-MN, the genes with the strongest negative predictability were TP53 followed by PPM1D. Prior to cytotoxic treatments, the median OS in patients with a CH-associated DNA repair mutation was significantly shorter than in those without any mutations (2.2 years vs. 9.0 years). Here, PPM1D is linked to cyclic hematopoiesis.