This paper reports an interesting case of myelodysplastic syndrome (MDS), whose bone marrow karyotype at diagnosis was 46, XY, t(16;17) (q12;q25). Fourteen months later, the disease transformed into erythroleukemia, and several correlative clones with hyperdiploid appeared at the same time. Thus, we consider that detecting karyotypic evolution may help evaluate the prognosis of MDS.