Valeria Santini, MD, University of Florence, Florence, Italy, shares her thoughts on the value of mutation screening and its impact on decision making in myelodysplastic syndromes (MDS). Accumulating evidence continues to support the importance of identifying somatic mutations to inform prognosis and guide therapeutic options. Additionally, the newly defined MIPSS-R (mutation combined with revised international prognostic scoring system) integrates molecular abnormalities into the current risk scoring system to improve patient stratification. Prof. Santini discusses mutational data she would consider in present day clinical practice and the next steps to move this field forward. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.