In MDS, bi‐allelic and not mono‐allelic TP53 alterations have been shown to predict for distinctly adverse outcomes and poor response to therapy,40, 41 thus “MDS with bi‐allelic TP53 alteration” has been proposed as a provisional entity in the upcoming 5th edition of the WHO classification of myeloid neoplasms and acute leukemia.42 This evidence concerns the gene TP53 and acute leukemia.