Higher pre-treatment IPSS-R cytogenetic scores, in particular, showed a predictable correlation with AML progression (p = 0.004) but they also showed an unexpected, although not significant, correlation with pre-treatment bone marrow fibrosis and pre- and post-treatment number of p53+ elements, giving us another glimpse into the complexity of MDS pathogenesis. This evidence concerns the gene TP53 and myelodysplastic syndrome.