DNA was extracted from peripheral blood (PureGene Blood Core Kit; Qiagen). Mutations were detected by either PCR amplification and Sanger sequencing, as described previously (11 (link), 41 (link)), whole-exome sequencing (29 (link), 37 (link)), whole-genome sequencing (35 ), or custom amplicon sequencing followed by confirmation with Sanger sequencing (12 (link)). For targeted panel sequencing, we designed a TruSeq Custom Amplicon probe set (Illumina) that included the coding and flanking intronic sequences of telomere genes (TERT, TR, DKC1, RTEL1, NAF1, TINF2, CTC1, PARN, NOP10, NHP2, TCAB1) and GATA2 (including the intron 4 enhancer). Libraries were generated from 500 ng of DNA according to manufacturer recommendations and analyzed on a MiSeq sequencer (Illumina) (12 (link)). The mean coverage of target sequence was 238× and 88% of the target sequences were covered at or greater than 8×.