In particular, patients diagnosed with MDS or bone marrow failure syndrome at a young age, a strong personal and/or family history of malignancy, and/or the identification of mutations (i.e., GATA2, CEBPA, DDX41, RUNX1) on next-generation sequencing (NGS)-based somatic cancer panels that may be germline events, should prompt a referral to genetic counseling for evaluation of a possible hematologic malignancy predisposition syndrome. Here, RUNX1 is linked to bone marrow failure syndrome.