Another puzzle is the mechanism(s) that underlies the elevated incidence of tumors, such as acute myeloid leukemia, colon carcinoma, and osteogenic sarcoma, in patients with inherited ribosomopathies such as Diamond–Blackfan anemia (DBA) caused by heterozygous mutations in RP genes including RPL5, RPL11, and to a lesser extent RPL19 and RPS26, or for RPS14 haploinsufficiency found in myelodysplastic syndromes (MDS) [139]. This evidence concerns the gene RPL19 and myelodysplastic syndrome.