In contrast, in patients within the ELN2022 adverse risk group, outcomes significantly differed according to the presence of a complex karyotype (at 3 years: CIR 59%, EFS 17%, OS 30%), other adverse cytogenetic aberrations (at 3 years: CIR 50%, EFS 32%, OS 54%), adverse risk gene mutation (i.e., ASXL1, RUNX1, or TP53, at 3 years: CIR 47%, EFS 42%, OS 58%), or myelodysplasia-related gene mutations (at 3 years: CIR 30%, EFS 55%, OS 73%, Fig. 3C, Supplementary Fig. S6E, F, and Supplementary Table S2). This evidence concerns the gene RUNX1 and Myelodysplasia.