Refractory acute myeloid leukemia (AML) has a poorly understood biology and prognosis. Here Christopher Hourigan, DM, DPhil, FACP, FRCP, of the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, discusses his group’s recent work in this area. Through transcriptomic analysis of treatment-naive AML, three chemorefractory patient groups with distinct expression profiles were identified. This interview took place at the 24th Congress of the European Hematology Association (EHA) 2019, held in Amsterdam, Netherlands.