Next generation anti-CD47 antibodies with reduced binding to RBCs due to cell type-specific glycosylation modification have been developed183–188 (Table 1 and Supplementary Table 1), some showing enhanced safety and efficacy in clinical trials.174,189–191 Lemzoparlimab, an anti-CD47 IgG4 antibody, enables a unique RBC-sparing property while retaining strong anti-tumor activity.188 Due to its promising early phase results,192–194 it is now being evaluated in MDS patients with azacitidine in a phase III clinical trial (NCT05709093). This evidence concerns the gene CD47 and myelodysplastic syndrome.