How likely is it that myelodysplastic syndromes will progress to acute myeloid leukemia?

How likely is it that MDS will progress to AML, and how long does it usually take? As I said, MDS is a very heterogeneous disease, and low-risk disease is low-risk because it progresses less often than high-risk MDS. But even in high-risk, there are certain chromosomal abnormalities that increase the risk of progression particularly therapy-related MDS, we call it. If they already received chemotherapy or radiation, they are at much higher risk of progression to leukemia and therapy-related MDS. And also if they have a mutation called TP53 or chromosomal abnormalities in the 17th chromosome, those are the patients that have high risk of progression. And sometimes if they have monosomal 7, they are also high risk of progression. And if they have complex cytogenetics, meaning more than three chromosomal abnormalities in the bone marrow. So those are the patients that are considered at high risk, and they have a high chance of progression to AML or leukemia in the next two to three years after diagnosis. So that's why we want to monitor them more closely, and sometimes we treat them as though they have an aggressive, almost like treatment is similar to leukemia with hypometallic treatment and also stem cell transplant.