In the ICC, all patients with mutated TP53 had high- or very high-risk IPSS-R/IPSS-M, whereas only one patient with MDS-SF3B1 had high-risk IPSS-M because of the presence of co-mutations including CBL, GATA2, and CEBPA. Moreover, MDS-EB subgroup patients were at higher risk according to IPSS-R or IPSS-M than MDS, NOS with SLD or MLD patients. This evidence concerns the gene TP53 and metachromatic leukodystrophy.