Pathways of CH in TBD. In the study by Gutierrez-Rodrigues et al, CH in patients with TBD was characterized by recurrent somatic mutations in genes related to telomere maintenance (green), DDR (pink), and RNA splicing (yellow). The authors found that mutations in TP53, gain of chromosome 1q, and U2AF1^S34 were associated with an increased risk of progression to MDS and AML. Professional illustration by Patrick Lane, ScEYEnce Studios.