By contrast, SAMD9L mutations, initially identified in ataxia-pancytopenia syndrome (ATXPC) and in myelodysplasia and leukemia syndrome with monosomy 7 syndrome (MSML7), seem to be associated with milder non-hematological disease manifestations like cerebellar dysfunction, beside cytopenia, immunodeficiency and predisposition to MDS, with a variable penetrance explained by hematopoietic somatic revertant mosaicism or compensatory effect of germline mutations [43,44]. This evidence concerns the gene SAMD9L and myelodysplastic syndrome.