In p53 positive MDS cases, p53 positivity could be identified in an earlier phase of the disease, namely refractory anemia (RA), and the transformation to OL could be exclusively observed in these p53‐positive RA cases.24 Therefore, p53 abnormalities might serve as a driver for the transformation of MDS to OL, rather than an initial step of MDS onset. Here, TP53 is linked to myelodysplastic syndrome with single lineage dysplasia.