Clinical investigation confirmed MDS-RS with hemoglobin at 12.1 g/dL, mean corpuscular volume of 103 fL, >40% RS, and 2 independent SF3B1 mutations (variant allele frequency [VAF] of 43% SF3B1N626D and 4.6% SF3B1K666N) without any other recurrent driver mutations. This evidence concerns the gene SF3B1 and myelodysplastic syndrome.