The authors analyzed a cohort of nearly 5,000 patients with AML for the prevalence and prognostic impact of IDH mutations and found distinct clinical and co-mutational features of the IDH1-R132C mutation. The study identified variable outcomes associated with distinct mutations of IDH and offers additional evidence in support of delineating the IDH2-R172K mutation as a distinct entity based on its co-mutational landscape and significant impact on outcome.