Raajit Rampal, MD, PhD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the role of genomics in disease progression in myeloproliferative neoplasms (MPNs). Dr Rampal first comments on the role of TP53 mutation in blastic phase transformation, and then highlights other events that contribute. To conclude, Dr Rampal explains how better understanding the genomics involved in disease progression may allow novel therapeutic approaches to be developed. This interview took place at the third annual Texas MPN Workshop (TMW) 2022, held in San Antonio, TX.