AQP4 and myeloid sarcoma: VRFs, including smoking, have been associated with increased disability and reduced quality of life in MS.1, –3 Smokers have been shown to have poor recovery from relapses in AQP4-NMOSD4 and increased risk of both magnetic resonance imaging (MRI) lesion persistence and poor clinical recovery in a combined cohort of AQP4-NMOSD and MOGAD patients.5 There are limited studies focusing on the prevalence of VRF6 and its correlation with neurological disability in AQP4-NMOSD.7,8 Dedicated VRF studies in MOGAD cohorts are absent.