To investigate if LEP promoter hypermethylation is an early event in myeloid neoplasm, occurring also at a cytopenic state before dysplasia is present, and if it is associated with disease prognosis, we investigated LEP promoter methylation in patients with ICUS, CCUS and MDS and in longitudinal samples and evaluated its association with clinical parameters and disease outcome. This evidence concerns the gene LEP and myelodysplastic syndrome.