Harnessing cutting-edge techniques to identify novel gene expression signatures in acute myeloid leukemia patients

Acute Myeloid Leukemia (AML) is a heterogeneous hematological malignancy with poor prognosis, despite therapeutic advances. Gene expression analysis has emerged as a powerful tool for identifying novel biological markers that can aid in predicting patient outcomes. This study is aimed to identify prognostic gene expression signatures from RNA-seq data of 457 AML patients.

Filtering methods were applied to reduce the set of genes, resulting in a subset of 685. Lasso-Cox, Bayesian Model Averaging (BMA), Random Survival Forest (RSF), and a Cox-time Neural Network (CtNN) were implemented to select the most promising prognostic genes. Explainable tools such as SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) were used to gain a deeper understanding of neural network outputs. An enrichment analysis was performed to identify enriched biological pathways.

SHAP and LIME interpretations of the CtNN output identified gene sets that differed from those selected by the other algorithms. According to the two-validation metrics the SHAP-derived signature demonstrated superior performance in the testing set. (C-index[95%CI]: 0.639[0.581-0.696] and Integrated Brier Score [95%CI]: 0.172[0.161-0.183]).

Enrichment analysis revealed structural and developmental pathways, emphasizing the role of microtubule dynamics and ciliary-related signaling in the bone marrow microenvironment.