TP53 and myelodysplastic syndrome: Although this study shows that the addition of HMA to the initial induction cannot improve the survival of elderly AML, in certain clinical situations, such as treatment of patients with complex karyotype, previous MDS history, TP53 mutation, HMA-based chemotherapy might be favored, because patients with adverse biology are not likely to respond to induction with low-intensity chemotherapy only, such as low-dose cytarabine.