Implications of Incorporating Myelodysplasia-Related Gene Variant Data on Acute Myeloid Leukemia Reclassification According to WHO-HAEM5 and ICC: A Large Multicenter Korean Cohort Study

Background: In the 5th edition of the WHO Classification of Hematopoietic Neoplasms (WHO-HAEM5) and the International Consensus Classification (ICC), acute myeloid leukemia (AML) diagnostic criteria were revised to incorporate genetic abnormalities, such as variants in myelodysplasia-related (MR) genes. As the implications of these changes on AML reclassification in Korean patients had not yet been fully evaluated, we comprehensively investigated them in this large-scale, multicenter study. Methods: variants) were collected and analyzed. All cases were reassessed according to both WHO-HAEM5 and ICC criteria. Results: " variants in the ICC. AML-MR was associated with older age, male predominance, and poorer survival compared with AML, not otherwise specified. Patients with recurrent fusion genes largely retained their original classification. Conclusions: -variant status in diagnosis influenced AML classification and risk stratification in our cohort, highlighting the potential importance of comprehensive molecular profiling in AML characterization.