The risk of tMN after initial GI cancer was significantly elevated after chemotherapy ± radiation exposure with G-CSF (HR = 3.24, 95% CI = 2.19 to 4.80, P < .0001); however, there was no increased risk in the absence of G-CSF exposure (HR = 1.06, 95% CI = 0.84 to 1.36; Table 1) compared to no chemotherapy and radiation (±G-CSF). The gene discussed is CSF3; the disease is therapy-related myeloid neoplasm.