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During the 64th American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub was pleased to speak to Alessandro Vannucchi, University of Florence, Florence, IT. We asked, How can chromosomal and mutation abnormalities in chronic myeloproliferative neoplasms (MPN) inform clinical decision making? Vannucchi opens by outlining the history of the discovery of gene mutations within MPN that have led to the development of the three classes of driver mutations: JAK2, MPL, and CALR. Vannucchi continues by discussing the recent developments and improvements in scoring criteria methods and considers the applications of these two factors in combination for patients with primary myelofibrosis. Vannucchi concludes that with improved scoring systems and the addition of novel molecular values, this can allow for patients to be better stratified within risk categories.