Bone marrow microenvironment and immunoinflammatory disorders as one of the key pathogenesis of MDS, so immunosuppressants may become an alternative treatment to demethylating drugs, however, there are still some patients who are insensitive to PD-1/PD-L1 or CTLA-4 monoclonal antibody, which requires us to continue to explore more potential targets in diseases such as MDS.T-cell immunoglobulin mucin 3 (TIM-3) is precisely in this context as a novel immune checkpoint that has received much attention. The gene discussed is CD274; the disease is myelodysplastic syndrome.