Substantial progress has been achieved in our understanding of the pathogenesis of MDS through the characterization of somatic gene mutations, such as gene encoding transcription factors (TP53 or ETV6), epigenetic regulators involved in methylation (DNMT3A), the hydroxymethylation of cytosine (TET2, IDH1, IDH2) or the covalent modifications of histones (EZH2, ASXL1)6, 7. Here, ASXL1 is linked to myelodysplastic syndrome.