Somatic DDX41-mutated clone size does not correlate with blast ratio or response to treatment. (A) Percentage of the cases that have DDX41 germ line variants is shown among the cases showing SD/PD with MC group sizes <0.10 (n = 10) and ≥0.10 (n = 147). P < .0001, using Fisher exact test. (B) Box plots showing the size of MC groups in pretreatment samples that have mutations in the genes indicated on x-axis. MC groups with somatic DDX41 mutations are highlighted with red color. P value is derived from a two-sided t test for comparison of pretreatment MC sizes represented by DDX41 and the other genes. (C) Box plots showing marrow blast percentage for the cases with or without DDX41 germ line mutations. P value is derived from a two-sided t test. (D) Paired box plots showing the changes in clone size between pre- and posttreatment samples with mutations in DDX41 (top) and TP53 (bottom). The same mutations are connected by lines. Colors of lines represent whether they are MC (black) or not (red). P values are derived from Jonckheere-Terpstra tests under the hypothesis that there is no correlation between clinical response and posttreatment clone sizes. (E) Kaplan-Meier estimates of OS per clone sizes in posttreatment samples. Cases with somatic DDX41 mutations (top; n = 27) and TP53 mutations (bottom; n = 92) are shown. The posttreatment clone sizes were divided by the median value for each gene. The number of the cases at risk at each time is indicated in the table below. P values are derived from two-sided log-rank tests. HI, hematological improvement.