Class progressions and development of AML. The proportions of each class that underwent class progression (A) or developed AML (B) are shown. For panel A, 170 patients in the whole cohort had genetic testing at a later follow-up date that allowed for assessing class progression, with only 30 of 170 patients progressing to a new class at follow-up (17.6%); the number with class progression and the number with follow-up testing are given in parentheses for each class. Of the classes we analyzed, the highest (DDX41) and second highest (TP53-CK, which could not progress to germ line–enriched DDX41) within the taxonomy hierarchy are not included. For panel B, the number that progressed to AML and the number in each class are given in parentheses (this analysis was performed on the whole cohort). ∗P < .05, ∗∗P < .01, ∗∗∗P < .001 compared with remaining patients in the cohort.