As shown in Figures 1A–C, the morphological assessment exhibited decreased cellularity, dysplasia of erythroid and myeloid cells (mild anisocytosis, teardrop cells, and binuclear myelocytes) and increased lymphoid cells; FCM determined the marrow blast percentage of 0.3% and growing lymphoid percentage of 62%; cytogenetics ascertained the abnormal karyotype of 45, XX, -5, -7, +add (9) (p15), -17, +mar [15]/46, XX [5]; MDS-associated genes revealed the TP53 mutation (c.711G>A, variant allele frequency (VAF) of 9.85%) and GATA2 mutation (c.848G>A, VAF of 45.58%). This evidence concerns the gene GATA2 and myelodysplastic syndrome.