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repaired, the p53-dependent apoptotic pathway is activated 9 yelodysplastic syndromes (MDS) are a heterogeneous group f clonal hematopoietic neoplasms, characterized by dysplasic findings with variable degree of bone marrow failure and roliferation of blast cells.1 It is the most common neoplastic isease of the bone marrow, with an estimated incidence f 1.3–5 per 100,000 people annually, and reaching 36 per 00,000 in patients aged 80 years or over. Risk factors include: dvanced age (MDS de novo, corresponding to 90% of cases), revious exposure to chemotherapy or radiation therapy therapy-related MDS), aplastic anemia and constitutional iseases, particularly those with abnormal DNA repair, such s Fanconi anemia.2 The clinical course is highly variable with survival ranging rom several years to a few months and variable risk of proression to acute myeloid leukemia (AML). Because of this eterogeneity, the study of prognostic factors is very imporant. Factors related to the individual (such as performance tatus, co-morbidities, age and nutritional status), biological severity of cytopenias, transfusion need, cytogenetic abnoralities, percentage of blasts, bone marrow fibrosis, primary r secondary disease) and social (access to health care and edications) impact the survival. The models most commonly sed in prognostic score for MDS de novo, such as the Internaional Prognostic Scoring System (IPSS), the WHO Prognostic coring System (WPSS), and the Revised International Prognotic Scoring System (IPSS-R) basically use biological variables, btained from the study of blood cell counts (cytopenias), per-

Scientific comment on tumor suppressor p53 protein expression: prognostic significance in patients with low-risk myelodysplastic syndrome