Risk Classification of Acute Myeloid Leukemia Based on Genetic Signatures at Initial Diagnosis

Favorable

t(15;17)(q24.1;q24.1)/PML::RARA

t(16;16) or inv(16)(p13.1q22)/CBFB::MYH11

t(8;21)/(q22;q22.1)/RUNX1::RUNX1T1

Mutated NPM1 without FLT3-ITD

bZIP in-frame mutated CEBPA

Intermediate

Normal karyotype with mutated NPM1 with FLT3-ITD

Wild-type NPM1 with FLT3-ITD (without adverse-risk genetic lesions)

t(9;11)(p21.3;q23.3)/MLLT3::KMT2A

Cytogenetic and/or molecular abnormalities not classified as favorable or adverse 

Poor

inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2)/GATA2::MECOM(EVI1)

t(3q26.2;v)/MECOM(EVI1)-rearranged

−5 or del(5q); −7; −17/abn(17p)

t(6;9)(p23.3;q34.1)/DEK::NUP214

t(v;11q23.3)/KMT2A-rearranged

t(9;22)(q34.1;q11.2)/BCR::ABL1

t(8;16)(p11.2;p13.3)/KAT6A::CREBBP

Monosomal karyotype

Complex karyotype defined as ≥ 3 unrelated chromosome abnormalities in the absence of other class-defining recurring genetic abnormalities; excluding hyperdiploid karyotypes with ≥ 3 trisomies (or polysomies) without structural abnormalities

Mutated ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, and/or ZRSR2

Mutated TP53