Thus, the high TGF-β1 expression levels observed in patients with HR-MDS (77) promote the development of an immunosuppressive microenvironment, characterized by a decrease in the CD4+ T-cell population, CD8+ T-cell exhaustion, decrease in NK-activating receptor expression, and increase of non-cytotoxic NK-cell counts (CD56bright) (78). The gene discussed is TGFB1; the disease is myelodysplastic syndrome.