A new case of myelodysplastic syndrome associated with t(3;3)(q21;q26) and inv(11)(p15q22).

A similar pattern of acquisition was never described before in MDS. The coexistence of two independent, high-risk oncogenic, rare events in the same clone suggests that there may be a functional constraint for synergy between the two events, leading to a proliferative advantage and suggests the utility of extended genotyping in myeloid malignancies.