“…The transcription-factor fusions were the first recognized somatic mutations in AML genomes, 1,2 and all such fusions have been shown to be relevant for disease initiation in mice. [39][40][41][42] Our data show that some mutations that are common in AML (e.g., in DNMT3A, NPM1, CEPBA, IDH1/2, and RUNX1) are mutually exclusive of the transcription-factor fusions, suggesting that these mutations may have functions in the initiation of AML that are similar to the functions of fusion genes. We also identified a pattern of mutual exclusivity for mutations in genes within certain biologic classes, including those encoding the cohesins, proteins of the spliceosome, signaling proteins, and histone-modifying proteins, suggesting that one mutation in these pathways is generally adequate for AML pathogenesis.…”