Prognosis is dismal for older patients with AML and Adverse-risk cytogenetics, including those with complex or monosomal karyotypes. Approximately one-third of patients in AZA-AML-001 had an Adverse karyotype; median OS among azacitidine-treated patients was almost double that of patients treated with CCR. Similarly, azacitidine-treated patients with monosomal or complex karyotypes had 35 and 36% reduced risks of death, respectively, compared with similar patients who received CCR.