To the Editor: Myelodysplastic syndrome (MDS) is a disease characterized by cytopenia, bone marrow dysplasia, and clonal hematopoiesis resulting from acquired mutations in hematopoietic stem cells, with a median of nine somatic mutations per exome, or ~1500 in the entire genome [1]. The mutational burden is related to its disease severity, with a lower number of mutations in low-risk MDS and higher numbers in high-risk disease and secondary acute myeloid leukemia [1, 2].
