Subgroups of AML patients defined by mutually exclusive genetic alterations. (A) Heatmap depicting gene mutations and balanced chromosomal translocations in 664 adult AML patients. Mutually exclusive gene signature analysis (MEGSA) identified 8 patient clusters (color coded at the top of the figure) based on almost mutually exclusive genetic alterations. The CBF rearrangements (RUNX1-RUNX1T1 and CBF-MYH11) were combined into 1 cluster in this analysis. The 9 resulting patient subgroups (8 mutually exclusive clusters and 1 subgroup comprising the remaining patients) differ with regard to co-occurring gene mutations and clinical characteristics. (B) RFS and (C) OS of the patient subgroups defined by mutually exclusive genetic alterations. Subgroups are color coded according to legend at the top of the figure. Patients with DEK-NUP214 were not included in both analyses, and patients with GATA2-MECOM were not included in the analysis of RFS, owing to small patient numbers.