# ELN 2022 risk classification

Source: https://onco.cc/terms/eln-risk/  
OnCo record `eln-risk` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The three-tier system (favourable, intermediate, adverse) that decides how aggressively an adult with AML is treated and whether a transplant is recommended.

## Summary

The European LeukemiaNet 2022 update classifies AML by genetics: favourable (t(8;21), inv(16), NPM1 without FLT3-ITD, bZIP in-frame CEBPA); intermediate (NPM1 with FLT3-ITD, FLT3-ITD without NPM1, t(9;11)); adverse (TP53, complex/monosomal karyotype, myelodysplasia-related mutations, KMT2A rearrangements other than t(9;11), inv(3), t(6;9)). FLT3-ITD allelic ratio was dropped in 2022 because FLT3 inhibitors changed the outlook. Companion ELN MRD recommendations define molecular and flow thresholds.

## Fields

- Kind: Term
- Last checked: 2026-09-07
- Also known as: ELN 2022 risk group; ELN 2022 genetic risk group; ELN genetic risk; ELN risk group; ELN favourable risk; ELN intermediate risk; ELN adverse risk; European LeukemiaNet risk; ELN 2017

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Acute_myeloid_leukemia
- ELN 2022 (Döhner et al., Blood 2022): https://ashpublications.org/blood/article/140/12/1345/485817

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Acute myeloid leukaemia in older or unfit patients](https://onco.cc/cancers/aml-older-unfit/), [FLT3-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-flt3/), [IDH1- and IDH2-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-idh/), [Myelodysplastic syndromes / neoplasms (MDS)](https://onco.cc/cancers/mds/), [Myeloproliferative neoplasms (PV, ET, myelofibrosis)](https://onco.cc/cancers/myeloproliferative-neoplasms/), [NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia](https://onco.cc/cancers/aml-npm1-kmt2a/), [Secondary and therapy-related acute myeloid leukaemia](https://onco.cc/cancers/aml-secondary/)
- technologies: [Allogeneic stem cell transplantation](https://onco.cc/technologies/allogeneic-hsct/), [Comprehensive genomic profiling](https://onco.cc/technologies/cgp/), [Cytogenetics and FISH](https://onco.cc/technologies/cytogenetics-fish/)
- targets: [FLT3](https://onco.cc/targets/flt3/), [KMT2A (MLL) rearrangement](https://onco.cc/targets/kmt2a/), [NPM1 mutation](https://onco.cc/targets/npm1/), [TP53](https://onco.cc/targets/tp53/)
- terms: [AML with myelodysplasia-related gene mutations (AML-MR)](https://onco.cc/terms/aml-myelodysplasia-related/), [FLT3-ITD allelic ratio](https://onco.cc/terms/flt3-itd-allelic-ratio/)
- trials: [RATIFY (CALGB 10603)](https://onco.cc/trials/ratify/)
- ideas: [MRD-guided transplant decisions in intermediate-risk AML](https://onco.cc/ideas/idea-mrd-guided-transplant-aml/)

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