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Interpretable Multi-Instance Learning Enables Early Prediction of Key Molecular Alterations from Routine Flow Cytometry in Acute Myeloid Leukemia

arXiv · AI, language, vision and robotics · article · Sep 16, 2026 · UTC

Background: Molecular testing for NPM1 and FLT3-ITD mutations guides critical early treatment decisions in acute myeloid leukemia (AML), but results can take weeks, long after these decisions must be made. Flow cytometry, already performed within hours of admission as part of routine care, may carry enough signal to predict these mutations directly, without added cost or delay. Methods: We developed an interpretable multi-instance learning classifier based on a decision tree, in which each patient sample is modeled as a collection of individual cells and mutation status is inferred from cell-l

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