Notably, such DNMT3A-mutated pre-leukemic cells were found in patients whose bulk leukemia cells also carried NPM1 and FLT3-ITD mutations, implying DNMT3A lesions arose earlier and persisted after the transient remission of the NPM1/FLT3-ITD-mutant leukemic clone. This evidence concerns the gene NPM1 and leukemia.