Fig. 1

Representative BM trephine biopsy, summary of the OncoScan copy number analysis and Kaplan–Meier analysis of overall survival. a–d BM morphology in a patient with high complexity genetic aberrations: a BM spaces are nearly devoid of fat cells and infiltrated by blast cells and residual dysplastic hematopoietic cells including micromegakaryocytes (arrow, hematoxylin and eosin, ×63). b Diffuse densely increased reticulin fiber meshwork consistent with BM fibrosis grade 3 (Gomori’s reticulin stain, ×63). c Accumulation of CD34-positive blast cells (CD34 immunohistochemistry, ×63). d Nuclear overexpression of the p53 protein in about 30% of nucleated cells (p53 immunohistochemistry, ×100). e Summary of the OncoScan copy number analysis showing the type of CNAs per chromosome in all patients using Nexus Express Software for OncoScan, blue color presents copy number gains and red color copy number losses. f Summary of the OncoScan copy number analysis showing the number of CNAs per patient. Stars inidicate the TP53 mutations in five patients identified via panel sequencing. g Kaplan–Meier analysis of overall survival (OS) of the total cohort. h Kaplan–Meier analysis of OS according to genomic complexity group. i Kaplan–Meier analysis of OS according to TP53 status as defined by: (#) no TP53 aberrations in the OncoScan assay and unknown mutational status by NGS; ($) TP53 aberrations in the OncoScan assay and/or TP53 mutations by NGS