Nomogram to Predict Clinical Outcome in FLT3-ITD Acute Myeloid Leukemia

Abstract Background Acute myeloid leukemia (AML) with FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutation is a hematologic malignancy presenting with different clinical therapeutic outcomes and prognoses. Objective to explore clinical variables related to overall survival (OS) and relapse-free survival (RFS), integrate these factors and build a nomogram model to evaluate the individual prognosis risk.Methods Some clinical variables were incorporated, including disease-related characteristics and individual factors. The independent prognostic factors associated with OS and RFS were established by univariate and multivariate Cox regression analysis. Statistically significant factors determined by multivariate Cox regression analysis were incorporated and integrated to develop nomogram model. The distinguishability and accuracy of the nomogram model were confirmed by the drawing of the concordance index (C index) and calibration curve.Results A total of 66 patients with FLT 3-ITD acute myeloid leukemia were selected for this study. Four variables: age, Eastern Cooperative Oncology Group performance score (ECOG score), status of complete remission at the first time (CR1) and with favorable prognosis gene were included in the nomogram to predict OS. Two variables: status of complete remission at the first time (CR1) and with favorable prognosis gene were included in the nomogram to predict RFS. The nomogram with clinical variables showed good predictive ability, which was measured by C index (OS 0.80, RFS 0.87) and a calibration curve drawing.Conclusions A nomogram model for predicting the prognosis of OS and RFS in patients with FLT3-ITD AML was successfully established. This would help physicians to accurately assess individual prognosis risk and guide treatment.