OS of patients with co-occurring mutations spanning multiple risk groups compared with patients with mutation(s) in a single ELN risk group. (A-D) Patients with mutations in ELN favorable and adverse-risk categories (B) had survival similar to that of patients classified as ELN favorable-risk, whereas patients with other combinations of mutations, such as ELN favorable– and intermediate–risk (predominantly comprised of patients with co-occurring NPM1 and FLT3 ITD mutations) (A); favorable-, intermediate-, and adverse-risk (C); and intermediate- and adverse-risk (D) had inferior outcomes.