A team of researchers of the University of Utah investigated the genetic basis underlying elevated hemoglobin in Andean natives, Aymara, by using granulocyte transcriptome data from both Aymara and Europeans from La Paz, Bolivia. Their findings are really important. The presence of Aymara enriched NFKB1 rs230511 haplotype decreases PV and ET inflammatory, prothrombotic, and HIF’s activity compared to NFKB1 wild allele. The NFKB1 rs230511 haplotype also modulates response to Ropeg in PV and ET. The presence of NFKB1 rs230511 T allele is associated with reduced expression of inflammatory and HIF-targeted genes, potentially decreasing inflammation and thrombosis risk in PV and ET. Could NFKB1 haplotype may impact Ropeg therapy efficacy and serve as a potential biomarker for response assessment in PV and ET patients? We asked Josef T. Prchal (Huntsman Cancer Institute – University of Utah, Salt Lake City), whom we met at ASH 2024 congress in San Diego.