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Clonal cytogenetic abnormalities occur in \u223c 30% of patients, while &gt;90% have gene mutations. Mutations involving <jats:italic>TET2<\/jats:italic> (\u223c60%), <jats:italic>SRSF2<\/jats:italic> (\u223c50%), <jats:italic>ASXL1<\/jats:italic> (\u223c40%) and the oncogenic <jats:italic>RAS<\/jats:italic> pathway (\u223c30%) are frequent; while the presence of <jats:italic>ASXL1<\/jats:italic> and <jats:italic>DNMT3A<\/jats:italic> mutations and the absence of <jats:italic>TET2<\/jats:italic> mutations negatively impact over\u2010all survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk stratification<\/jats:title><jats:p>Molecularly integrated prognostic models include; the Groupe Fran\u00e7ais des My\u00e9lodysplasies (GFM), Mayo Molecular Model (MMM), and the CMML specific prognostic model (CPSS\u2010Mol). Risk factors incorporated into the MMM include presence of nonsense or frameshift <jats:italic>ASXL1<\/jats:italic> mutations, absolute monocyte count\u2009&gt;\u200910 \u00d7 10<jats:sup>9<\/jats:sup>\/L, hemoglobin &lt;10 gm\/dL, platelet count &lt;100 \u00d7 10<jats:sup>9<\/jats:sup>\/L and the presence of circulating immature myeloid cells. The MMM stratifies CMML patients into 4 groups; high (\u22653 risk factors), intermediate\u20102 (2 risk factors), intermediate\u20101 (1 risk factor), and low (no risk factors), with median survivals of 16, 31, 59, and 97 months, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk\u2010adapted therapy<\/jats:title><jats:p>Hypomethylating agents such as 5\u2010azacitidine and decitabine are commonly used, with overall response rates of \u223c30%\u201040% and complete remission rates of \u223c7%\u201017%; with no impact on mutational allele burdens. 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