Thus, MDS’ with indolent behavior, such as isolated 5q deletion or SF3B1 rarely presents at diagnosis with excess blasts, whereas MDS with AML-like mutations (DNMT3A, NPM1, FLT3, IDH1, and RUNX1) almost exclusively presented with excess blasts (54). The gene discussed is DNMT3A; the disease is myelodysplastic syndrome.