A 68-year-old man presents with fatigue and pancytopenia. Bone marrow biopsy shows 35% blasts. Cytogenetics reveal the karyotype marked **B** in the diagram: monosomy 7, deletion 5q, and trisomy 8. Molecular testing shows TP53 mutation. According to the 2022 ELN guidelines, what is the risk stratification and most appropriate initial management for this patient?
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