Thus, stratification upon ASXL1 and TP53 mutation, which identified two distinct biological subgroups among AML-MRC, was the only significant predictor of outcome while usual cytogenetic risk classification or the different criteria defining AML-MRC (prior MDS or MDS/MPN, MDS-related cytogenetics and MLD) failed to predict patient outcome in our series. Here, ASXL1 is linked to myelodysplastic syndrome.