When IPSS-R was applied to our cohort of MDS with isolated +8, 23.5% of patients included in the low-risk category and 52.4% of intermediate-risk cases categorized by the IPSS-R, showed worse outcomes and were described as high-risk isolated +8 patients due to the presence of mutations in STAG2, SRSF2 and/or RUNX1 (Figure 3a). This evidence concerns the gene RUNX1 and myelodysplastic syndrome.