Figure 3.

Combining somatic mutations with known risk factors and prognostic models. (A–C) Data from Bejar et al.³⁸ is used to compare overall survival in patients with one or more prognostically adverse mutations (in TP53, EZH2, RUNX1, ASXL1, or ETV6) to unmutated patients within each of the IPSS-R ‘lower’ risk groups. Mutations identify added disease risk in each of the categories. (D) Overall survival of patients with complex disease karyotypes is strongly stratified by TP53 mutation status. Patients with both a complex karyotype and TP53 mutation have a very short overall survival whereas complex karyotype patients without a TP53 mutation have a survival that is comparable to that of MDS patients with non-complex karyotypes. (E) Overall survival in 611 MDS patients examined by Haferlach et al.⁴⁰ and stratified according to a mutation-only prognostic model considering the weighted contribution of mutations in 14 genes. (F) Overall survival in the same 611 patients risk stratified by a prognostic model that combines both clinical features and the mutation status of 14 genes. Reprinted with permission.