The authors confirmed the role of the MEK/Erk and PI3K/Akt signaling pathway in the transformation of MDS to AML by modulating histone methylation via the trimethylation of H3 on lysine 27 (H3K27me3) methylase and demethylase pathways and by regulating distal-less homeobox 5 (DLX5) gene transcription which gene has previously determined to have an anti-tumor effect in AML an MDS [91, 92]. This evidence concerns the gene DLX5 and myelodysplastic syndrome.