Unlike their true MDS counterparts, these cases typically lack the tell-tale dysplasia seen in MDS and they will have mutations that are otherwise exclusively seen in AML such as RUNX1::RUNX1T1, CBF::MYH11, or mutated NPM1. These patients have demographic and disease characteristics similar to patients with de novo AML, and the disease behavior is also more akin to that of de novo AML. The gene discussed is NPM1; the disease is myelodysplastic syndrome.