Prognostic impact of RAS-pathway mutations in patients with myelofibrosis

RAS -pathway mutations are recurrent events in myeloid malignancies. However, there is limited data on the significance of RAS -pathway mutations in patients with myelofibrosis (MF). We analyzed next-generation sequencing data of 16 genes, including RAS-pathway genes, from 723 patients with primary and secondary MF across three international centers and evaluated their significance. N/KRAS variants were present in 6% of patients and were typically sub-clonal (median VAF = 20%) relative to other genes variants. RAS variants were associated with advanced MF features including leukocytosis ( p = 0.02), high somatic mutation burden ( p