Large oncogenomes are characterized by acquired mutations in DNA repair genes. (A) Experimental setup including oncogenomes (OG). For patients 202 and 735, no material of the initial leukemia (INIT) was available; patient 107 did not relapse before allo-SCT. (B) Sizes of the individual oncogenomes. (C) Mutational loads across the oncogenomes. The increase from OG1 vs OG2/OG3 was statistically significant (P = .005). (D) Mutations in DNA polymerase/repair genes explaining the large oncogenomes. n/a, not available; REMI, first remission; RLPS, first relapse; TREMI, remission after allo-SCT; TRLPS, relapse after allo-SCT; UPN, unique patient identifier.