Considering the combination of common risk genes (e.g. CALCRL and HOPX) and immune-related markers (e.g. ID2, LSP1, NPDC1, and IL32) in the ACEsig, this score system may capture features unrecognized among cytogenetically normal AML (CN-AML) patients who lack chromosomal abnormalities, a major prognostic factor in AML. Here, HOPX is linked to acute myeloid leukemia.