The largest series of patients with a primary, untreated MDS described a median OS of 26.7 months and a median AML-free survival of 78 months.2 However, also due to the low number of patients showing 11q23/MLL translocations in MDS, their real prognostic impact is not well defined for this hematologic entity. Here, KMT2A is linked to myelodysplastic syndrome.