While the relative risk of each mutation for progression to leukemia is not clearly established, mutations in NRAS, KRAS, and fms-like tyrosine kinase-3 (FLT3) was seen in approximately 40% of MDS patients at the time of transformation [10] and, when found, patients have a shorter time to transformation and a shorter survival [51,79]. Here, FLT3 is linked to myelodysplastic syndrome.