Premalignant clonal hematopoiesis underlies NPM1^wtrelapse. (A) For 9/11 patients, 2 remission samples/patient were available for sequencing analysis. Eights of 9 patients showed persistent mutations in CMR and 4 patients acquired additional mutations before the onset of relapse. (B) Mutations in 6 genes detected at diagnosis were found to persist in remission. Shown is the fraction of persistent mutations in relation to all 9 patients. (C) VAF of persisting mutations at diagnosis, CMR, and relapse. Black line, median; CR, complete remission.