人工智能方法来估计在现代时代的异构HCT后的整体死亡率和非复发死亡率:EBMT-TCWP研究
A Mussetti1, B Rius-Sansalvador2,3, V Moreno2,3
1Department of Haematology, Institut Català d'Oncologia - Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain. amussetti@iconcologia.net.
Bone marrow transplantation
|November 25, 2023
概括
全源性造血细胞移植 (alloHCT) 的新预后得分对患者目前的整体死亡率 (OM) 和非复发性死亡率 (NRM) 的风险进行了分层. 虽然有效,但它并没有显著提高对现有模型的预测准确性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 全基性造血细胞移植 (alloHCT) 提供治愈潜力,但受到毒性限制.
- 现有的预后得分往往不反映当前患者群体或使用替代捐赠者的情况.
- 在当前的 alloHCT 时代,需要更新的预测工具.
研究的目的:
- 在接受allHCT的成年患者中开发和验证总死亡率 (OM) 的新型预后得分.
- 使用开发的OM得分来预测非复发性死亡率 (NRM).
- 为了评估分数在当代allHCT景观中的表现.
主要方法:
- 利用了来自EBMT注册表的33927名成年患者的大数据集,这些患者在2010-2019年期间接受了alloHCT.
- 采用人工智能 (AI) 技术,包括OM的梯度提升和NRM的弹性网.
- 该模型在不同的数据子集 (70%,15%,15%) 上进行了训练,优化和验证.
主要成果:
- 对OM的梯度增强模型实现了0.64的AUC,对NRM的弹性网模型实现了0.62.6的AUC.
- 开发的得分有效地将患者分为不同的风险组,两年OM范围从18% (最低得分) 到82% (最高得分).
- 同样,两年的NRM从13% (最低得分) 到93% (最高得分) 不等,在一般队列和单一的子集中一致.
结论:
- 新的预后得分有效地分层了当代aloHCT患者OM和NRM的风险.
- 虽然得分证明了风险分层的有用性,但与现有方法相比,它并没有显著改善死亡率预测.
- 未来的研究应侧重于纳入生物或动态移植后标记物,以提高预后准确性.
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