{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:22:16Z","timestamp":1789593736207,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The 2022 WHO and ICC classifications introduced conflicting definitions for myelodysplasia\u2010related acute myeloid leukemia (AML\u2010MR) and myelodysplastic syndrome\/AML (MDS\/AML), leading to diagnostic uncertainty. This study compared the molecular and clinical characteristics of these entities to clarify their relationship. We conducted a multicenter retrospective study of 568 AML and 75 MDS\/AML patients from a Chinese cohort, with findings validated in two independent public cohorts (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0524). Molecular features, treatment responses, and overall survival (OS) were compared across subgroups defined by WHO and ICC criteria. AML\u2010MR and MDS\/AML patients exhibited overlapping molecular features, including frequent ASXL1 (25.0% vs. 22.7%) and TP53 mutations (19.4% vs. 12.0%), as well as a high incidence of complex karyotypes (24.4% vs. 21.3%). Non\u2010AML\u2010MR cases had significantly lower frequencies of these alterations but were enriched for NPM1 and FLT3 mutations (all\n                    <jats:italic>p\u00a0&lt;\u00a00.05<\/jats:italic>\n                    ). AML\u2010MR patients had significantly shorter OS than Non\u2010AML\u2010MR patients across both classification systems (median OS: 10.3 vs.\u00a0&gt;\u00a022\u00a0months,\n                    <jats:italic>p\u00a0&lt;\u00a00.001<\/jats:italic>\n                    ), but comparable remission rates (\n                    <jats:italic>p\u00a0=\u00a00.514<\/jats:italic>\n                    ) and OS (10.3 vs. 13.3\u00a0months,\n                    <jats:italic>p\u00a0=\u00a00.425<\/jats:italic>\n                    ) to MDS\/AML. IPSS\u2010R and IPSS\u2010M showed no prognostic discrimination in either group (\n                    <jats:italic>p\u00a0&gt;\u00a00.05<\/jats:italic>\n                    ), while ELN 2022 showed limited predictive performance. In response, we developed a modified risk stratification model that categorized patients into three risk groups with distinct survival outcomes (median OS: 21.7, 8.5, and 5.7\u00a0months;\n                    <jats:italic>p\u00a0&lt;\u00a00.0001<\/jats:italic>\n                    ). This model remained discriminatory within the AML\u2010MR (13.7 vs. 8.5 vs. 5.6\u00a0months,\n                    <jats:italic>p\u00a0=\u00a00.001<\/jats:italic>\n                    ) and MDS\/AML (31.2 vs. 11.7 vs. 6.3\u00a0months,\n                    <jats:italic>p\u00a0=\u00a00.0044<\/jats:italic>\n                    ) subgroups and was validated in external cohorts (\n                    <jats:italic>p\u00a0&lt;\u00a00.01<\/jats:italic>\n                    ). AML\u2010MR and MDS\/AML form a biological continuum with shared molecular and clinical features, supporting the ICC classification update. Our integrated model may improve prognostic stratification and guide clinical decision\u2010making for these high\u2010risk patients.\n                  <\/jats:p>","DOI":"10.1002\/hon.70174","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:19:58Z","timestamp":1772965198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of ICC and WHO Classifications Reveals Molecular and Clinical Convergence Between AML\u2010MR and MDS\/AML"],"prefix":"10.1002","volume":"44","author":[{"given":"Yanhui","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Hematology Zhongda Hospital School of Medicine Southeast University Institute of Hematology Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Hematology Zhongda Hospital School of Medicine Southeast University Institute of Hematology Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Hematology Xuzhou Central Hospital  Xuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimei","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Hematology The First People's Hospital of Lianyungang  Lianyungang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Haematology Puyang Oilfield General Hospital  Puyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxu","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of Haematology Puyang Oilfield General Hospital  Puyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology Puyang People's Hospital  Puyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchun","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Hematology Zhongda Hospital School of Medicine Southeast University Institute of Hematology Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology Affiliated Hospital of Yangzhou University  Yangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-1612","authenticated-orcid":false,"given":"Zheng","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Hematology Zhongda Hospital School of Medicine Southeast University Institute of Hematology Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010022\u201001613\u20101"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5421"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes11080845"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102016\u201003\u2010643544"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011869"},{"key":"e_1_2_13_8_1","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow S. 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