In the multivariate analysis, DM (HR 1.050 CI 0.765–1.442, p = 0.762) did not retained its prognostic significance in a Cox regression analysis model, while elderly age (HR 1.728 CI 1.255–2.379, p = 0.001), higher BM blasts percentage (HR 1.946 CI 1.438–2.632, p = 0.000), poor cytogengtic (HR 1.657 CI 1.256–2.187, p = 0.000), lower IPSS-R risk (HR 0.628 CI 0.405–0.974, p = 0.038), infection (HR 2.488 CI 1.749–3.538, p = 0.000), TP53 mutation (HR 1.880 CI 1.222–2.893, p = 0.004), and TET2 mutation (HR 1.565 CI 1.090–2.249, p = 0.005) affected on OS in all MDS patients independently (Table 2). Here, TET2 is linked to myelodysplastic syndrome.