Table 1. ELN risk classification for... | American Society of Hematology

Table 1.

ELN risk classification for patients receiving less-intensive therapies (ELN 2024 Less-Intensive)

Risk category	Genetic abnormality
Favorable	Mutated NPM1 (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt) Mutated IDH2 (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt) Mutated IDH1∗ (TP53^wt) Mutated DDX41†, Other cytogenetic and/or molecular abnormalities‡ (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt)
Intermediate	Other cytogenetic and molecular abnormalities‡ (FLT3-ITD^pos and/or NRAS^mut and/or KRAS^mut; TP53^wt)
Adverse	Mutated TP53

Risk category	Genetic abnormality
Favorable	Mutated NPM1 (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt) Mutated IDH2 (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt) Mutated IDH1∗ (TP53^wt) Mutated DDX41†, Other cytogenetic and/or molecular abnormalities‡ (FLT3-ITD^neg, NRAS^wt, KRAS^wt, TP53^wt)
Intermediate	Other cytogenetic and molecular abnormalities‡ (FLT3-ITD^pos and/or NRAS^mut and/or KRAS^mut; TP53^wt)
Adverse	Mutated TP53

This classification does not apply to patients who have received prior treatment with an HMA.

∗

Favorable risk applies specifically to patients treated with AZA + IVO, irrespective of the presence of activating signaling gene mutations.

†

Identification of a DDX41 mutation at near-heterozygous frequency should prompt consideration of germ line DDX41 mutation.

‡

For many cytogenetic and molecular abnormalities, single or as coaberrations, no data are currently available; they are tentatively categorized as favorable and intermediate-risk depending on the absence or presence of activating signaling gene mutations.

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