Construction of a predictive model based on the risk of relapse after cytarabine consolidation therapy in AML patients

Abstract Background Patients with acute myeloid leukemia (AML) are still at risk of relapse after consolidation therapy with cytarabine. Therefore, early identification and intervention of patient s at high risk of relapse is crucial. Methods This single-center retrospective study analyzed the clinical data of 355 patients with AML (non-APL) who received cytarabine consolidation therapy. Key factors affecting relapse were identified by least absolute shrinkage and selection operator regression, and a predictive model for relapse after cytarabine consolidation therapy was constructed and internally validated. Results The study showed that age ≥ 50 years, female, DNMT3A mutation, TP53 mutation, IDH1 mutation, CBF-AML mutation, white blood cell (WBC) ≥ 30 × 109/L, 1-2 courses of induction therapy, 1-2 courses of cytarabine consolidation therapy and cumulative dose of cytarabine 36 g were significantly correlated with relapse after cytarabine consolidation therapy in AML patients. Constructing a nomogram using the above factors and validating it with receiver operating characteristic, calibration curves showed that it has good discrimination and prediction. Patients were categorized into high-risk and low-risk groups based on the median risk score of the model, and there were significant differences in overall survival and event-free survival between the two groups. Conclusion Predictive models based on age, sex, DNMT3A, TP53, IDH1, CBF-AML, WBC count, induction therapy course, cytarabine consolidation course, and cumulative dose can effectively assess the relapse risk after receiving cytarabine consolidation therapy in AML patients and provide a reference for clinical decision-making. Implications for practice Based on Chinese AML patients as the study base, this study identifies independent prognostic factors affecting relapse after cytarabine consolidation therapy, and proposes a predictive model to assess the risk of early relapse in AML patients after receiving cytarabine consolidation therapy. This may provide a reference for clinicians to guide personalized treatment.