TP53 and RAS pathway mutations co-occur in human AML and predict an inferior outcome. (A) Variant allele frequency (VAF) of RAS pathway mutations and TP53 mutations in co-mutated patients. The degree of shading in each box corresponds to the VAF of that mutation. Patients with complex cytogenetics are shaded in black. Details of complex cytogenetics and VAF information are included in supplemental Table 1. (B) Fish plot of a representative case with sequential sampling that acquired TP53 mutations at the time of AML transformation and then an NRAS mutation during AML relapse. Red-colored mutations highlight acquired genetic events. (C) Fish plot of a representative patient with sequential sampling who lost a KRAS mutation at the time of clinical remission with induction chemotherapy. Red-colored mutation highlights the lost genetic event. (D) Overall survival of TP53 and RAS pathway mutated cohort (n = 8) vs the TP53 mutated cohort (n = 55 patients with survival data) vs the RAS pathway mutated cohort (n = 154 patients with survival data). P values were determined by the log-rank test. sAML, secondary AML.