For instance, AML with a complex or monosomal karyotype, structural abnormalities involving chromosome 3, TP53 mutations, high allelic ratio FLT3 mutations, or mutations in ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, and ZRSR2 (classified as AML with myelodysplasia-related gene mutations),140 are associated with treatment resistance and relapse, placing it in the ELN 2022 adverse prognostic group.139. This evidence concerns the gene ZRSR2 and acute myeloid leukemia.