In patients with MDS, the inflammatory pathways of MSCs are overactivated, and these pathways include the NF-B, EGF, TGF-β, and TNF-α, which hinder hematopoiesis in LR-MDS; this is considered to be responsible for the increased apoptosis rates observed at this stage of the disease (30, 42). Here, TNF is linked to myelodysplastic syndrome.