ELN 2022 Risk (AML)

In the 2017 criteria, FLT3-ITD was stratified by allelic ratio and NPM1 status. In the 2022 update, all FLT3-ITD cases (in the absence of adverse-risk mutations) are classified as "Intermediate Risk." This reflects the widespread use of Midostaurin, which has improved the prognosis of this subgroup.

TP53 mutations are the most adverse feature in AML. In 2022, the "Adverse" category specifically includes TP53 mutations with a VAF > 10%, often associated with a complex karyotype and resistance to standard intensive chemotherapy.