Related Experiment Video
Updated: Mar 3, 2026
Constructing and Visualizing Models using Mime-based Machine-learning Framework
Published on: July 22, 2025
Nomogram-based prediction models for clinical outcomes in pediatric RUNX1::RUNX1T1-positive acute myeloid leukemia: a
Xiaoli Chen1,2, Luyang Zhang1,2, Yangyang Zheng3
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Objective:
To identify prognostic factors and develop nomograms predicting short-term mortality and relapse in pediatric RUNX1::RUNX1T1-positive AML, thereby enabling individualized risk assessment and optimizing clinical management.
Methods:
We retrospectively analyzed 136 pediatric patients with RUNX1::RUNX1T1-positive AML who achieved morphologic complete remission (CR) after one induction course under AML-CAMS-2009 or AML-CAMS-2016 regimen. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression identified independent predictors of 3-year overall survival (OS) and relapse-free survival (RFS). Nomograms were built from these predictors. Model performance was assessed by time-dependent receiver operating characteristic (ROC) curves, calibration plots, decision curve analysis (DCA), and concordance index (C-index), with internal validation performed by bootstrap resampling.
Results:
High-Risk measurable residual disease (MRD), treatment regimen, and diagnostic white blood cell (WBC) group (≥20×10⁹/L vs. <20×10⁹/L) independently predicted OS. For RFS, independent predictors were percentage of bone marrow blasts by flow cytometry (BM blasts [FCM]), extramedullary infiltration (EMI), High-Risk MRD, treatment regimen, and WBC group. Nomograms demonstrated strong discrimination and calibration with superior clinical net benefit versus any single predictor. Nomogram-derived scores stratified patients into prognostically distinct subgroups with significant differences in OS and RFS.
Conclusions:
This study established internally validated 3-year OS and RFS nomograms for pediatric RUNX1::RUNX1T1-positive AML with excellent discrimination and clinical utility. Prospective multicenter validation is warranted to confirm the robustness and facilitate clinical adoption.
