Genetic signatures in LR MDS demonstrate morphologic orientation. (A) Decision tree defining a genetic signature with 8 subtypes for LR MDS patients (LR-SA through LR-SH). The decision process initiates with SF3B1 (depicted with a square and orange arrow). Incidences of individual mutations are evaluated in a sequence to assign patients to the 8 subtypes. Plus and minus signs depict mutated and wild type, respectively. (B) Distributions of mutations within each genetic signature. Genes used in the decision tree are shown. (C) Network representation of the signature. Nodes define patients, color is used to describe their subtypes, and edges are drawn between neighboring patients with commensurate mutational patterns as defined by the statistical model. (D) Kaplan-Meier curves compare overall survival among patients assigned to the 8 genetic signatures; the P value is from the log-rank test. (E) Distribution of morphologic profiles among the genetic signatures. Frequent profiles (>30%) in each genetic signature are depicted. (F) The presence of specific morphologic features among morphologic profiles and genetic signatures. Morphologic parameters are ordered as rows; frequent pairs of morphologic profiles and genetic signature are displayed as columns.