Machine Learning for Multi-Omics Characterization of Blood Cancers: A Systematic Review

Artificial Intelligence and machine learning are increasingly used to interrogate complex biological data. This systematic review evaluates their application to multi-omics for the molecular characterization of hematological malignancies, an area with unmet clinical need. We searched PubMed, Embase, Institute of Electrical and Electronics Engineers Xplore, and Web of Science from January 2015 to December 2024. Two reviewers screened records, extracted data, and used a modified appraisal emphasizing explainability, performance, reproducibility, and ethics. From 2847 records, 89 studies met inclusion criteria. Studies focused on acute myeloid leukemia (34), acute lymphoblastic leukemia (23), and multiple myeloma (18). Other hematological diseases were less frequently studied. Methods included Support Vector Machines, Random Forests, and deep learning (28, 25, and 24 studies). Multi-omics integration was reported in 23 studies. External validation occurred in 31 studies, and explainability in 19. The median diagnostic area under the curve was 0.87 (interquartile range 0.81 to 0.94); deep learning reached 0.91 but offered the least explainability. Artificial Intelligence and machine learning show promise for molecular characterization, yet gaps in validation, interpretability, and standardization remain. Priorities include external validation, interpretable modeling, harmonized evaluation, and standardized reporting with shared benchmarks to enable safe, reproducible clinical translation.