Among the most highly expressed genes in the MDS clusters were genes associated with AML as for example, CD9950,51, EpCAM, related to enhanced cell survival, diminished mitochondrial metabolism, ribosome biogenesis, and differentiation capacity and an activated transcriptomic signature associated with AML52 (Fig. 7F and Supplementary Fig. 8D), ID1, which is expressed by AML cells and has been shown to increase leukaemic proliferation and promote tumour progression by impairing myeloid differentiation53,54, ID3, which promotes erythroid differentiation55,56 (Supplementary Fig. 8D). Here, EPCAM is linked to neoplasm.