TP53 and myelodysplastic syndrome: Some other studies have confirmed that double minutes (DMs, a kind of ecDNA) in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are associated with micronuclei, MYC or MLL amplification, complex karyotype, monosomal karyotype, TP53 deletion, and TP53 mutations [13, 14].