Survival outcomes in patients with complex karyotypes, normal karyotypes, and a high or low number of clonal evolutions. (A) OS in patients with or without complex karyotypes. (B) Incidence of ATL-related death in patients with or without complex karyotypes. (C) OS in patients with normal vs abnormal karyotypes. (D) Incidence of ATL-related death in patients with normal vs abnormal karyotypes. (E) OS in patients with a high vs low number of clonal evolutions. (F) Incidence of ATL-related death in patients with a high vs low number of clonal evolutions.