Therefore, we recommend establishing the HFE gene mutation status (and in the future probably also other iron-storage-related genes) in patients with MDS, at least when these patients present with signs of increased iron uptake before transfusion therapy (elevated serum ferritin, transferrin saturation > 70%), or have a case history of familial haemochromatosis, or have a rapid increase in serum ferritin levels after starting transfusion therapy. Here, HFE is linked to myelodysplastic syndrome.