The 2024 WHO classification highlight the rapid progression of myelodysplastic syndrome (MDS) or MDS/myeloproliferative neoplasm (MPN) with NPM1 mutations to AML16,17, underscoring the importance of early detection, especially in cases with less than 20% leukemia cells or evidence of multilineage dysplasia. This evidence concerns the gene NPM1 and myelodysplastic syndrome.