Early muts in DNMT3A, TET2, and ASXL1 differentially shape the subsequent evolution of AML from diagnosis (diag) through REL. (A) Upset plot indicating the number of patients at diag (n = 182) with muts in DNMT3A, TET2, and ASXL1. The number of patients per group is indicated above each bar. (B) Co-mut analysis of FLT3, NPM1, CBL, and SRSF2 in relation to DNMT3A, TET2, or ASXL1 across the entire cohort. Dots are color-coded by logORs and size-scaled by statistical significance (Fisher's 2-sided exact test). Asterisks denote P < .05. (C) Bar plot detailing the frequency of FLT3, NPM1, CBL, or SRSF2 muts in a cohort of patients with untreated MDS,⁴¹ stratified by DNMT3A, TET2, and ASXL1 mut status. Statistical significance was assessed by Fisher's 2-sided exact test. mut freq, mutation frequency; OR, odds ratio.