Prithviraj Bose, MD, University of Texas MD Anderson Cancer Center, Houston, TX, reflects on exciting abstracts presented at ASH 2020 within the field of myeloproliferative neoplasms (MPNs). Firstly, the late-breaking abstract showing how driver mutations can be acquired very early in life and manifest clinically over decades. Additionally, studies have recently shown the survival of patients with myelofibrosis is increasing, partially due to ruxolitinib. Finally, advances in the understanding of MPNs biology have been presented, including the potential high molecular risk mutations in NFE2 and SF3B1. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.