RPL23 was reported that it negatively regulated apoptosis via the RPL23/Miz-1/c-Myc circuit in higher-risk myelodysplastic syndrome (12), functionally inhibit the HDM2 ubiquitin ligase and thereby activate p53, leading to growth inhibition and anti-tumour effects in cases of gastric cancer (27). This evidence concerns the gene MDM2 and myelodysplastic syndrome.