RBC-TD is associated with poor prognosis independent of the IPSS-M. (A) OS was progressively shorter in higher-risk IPSS-M categories. (B) The rate of RBC-TD increases with higher-risk IPSS-M. RBC-TD was associated with poor OS in the whole cohort (C), HMA-treated patients (D), and lower- (E), and higher-risk (F) IPSS-M subgroups. (G) In a multivariable Cox proportional hazards analysis, RBC-TD was associated with poor OS independent to IPSS-M category, age at diagnosis, and sex. (H) Importantly, patients with LTB and HTB groups had poorer prognosis compared with patients with MTB. MTB, minimal transfusion burden; NA, not available.