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Prof. Valeria Santini, an expert on MDS from the University of Florence, discusses what we currently know about genetic mutations and cytogenetic changes associated with better myelodysplastic syndromes (MDS) treatment outcomes. For example, changes in chromosome 5 (some 5q deletions) can indicate a favorable response to treatment with lenalidomide. A mutation in the gene SF3B1 can also indicate a good prognosis. Prof. Santini discusses the need for transfusion and the role of multiple mutations.