Our results suggest that APAF1 may be implicated in the acquisition of a more aggressive phenotype in MDS. Cytogenetic analysis is one of important risk factors for predicting leukemic evolution.25 In addition, a recent study provides new information about the role of cytogenetic analysis in diagnosis, prognosis and follow-up of patients with hypocellular primary MDS.26 In our analysis, a correlation with chromosomal aberrations was elicited for APAF1 promoter methylation. The gene discussed is APAF1; the disease is myelodysplastic syndrome.