Silent CH and its associated hazards. (A) Comparison of number of patients with silent CH vs conventional CH. (B) Variant classes contributing to silent CH. (C) Age distribution of conventional and silent CH mutations. (D) Comparison of the VAF distributions of silent and conventional CH variants. (E) Number of specific single DNA base alterations in conventional and silent CH, and number of more complex alterations in each group. (F) Histogram showing number of observations of specific DNA variants in conventional and silent CH groups. (G) HR for hematologic malignancy in patients with conventional vs silent CH. Silent CH has minimal significance as an isolated finding at low VAF in a single gene but attains significance and expands the number of higher risk patients identifiable when it is present in combination with other mutations and/or when VAF is >0.1. HRs and P values were calculated using a multivariate competing risk regression, adjusting for age, gender, and cancer type.