机器学习预测工具用于针对状细胞疾病的血造细胞移植结果的个性化预测:基于注册表的研究
Rajagopal Subramaniam Chandrasekar1,2, Michael Kane3, Lakshmanan Krishnamurti1
1Section of Pediatric Hematology/Oncology/BMT, Yale School of Medicine, 2073 A, LMP Builidng 330 Cedar Streeet, New Haven, CT, United States, 1 412-612-4761.
JMIR AI
|September 15, 2025
概括
一个新的机器学习模型SPRIGHT准确地预测了接受血造细胞移植 (HCT) 的状细胞病患者的个体结果. 该工具通过评估HCT后的移植失败和血管闭塞危机等事件的风险来帮助临床决策.
科学领域:
- 计算生物学是一种计算生物学.
- 血液学 血液学 血液学
- 机器学习在医学中的应用
背景情况:
- 血造细胞移植 (HCT) 提供了状细胞疾病 (SCD) 的治愈潜力,但个体结果预测仍然不确定.
- 现有的注册研究缺乏对SCD中HCT结果的个性化风险评估.
- 机器学习 (ML) 可以识别预测模式并量化不确定性,以改善SCD的临床决策.
研究的目的:
- 开发和验证SPRIGHT,一个个性化的ML预测模型,用于SCD中关键的HCT后临床结果.
- 结合多个HCT前的特征来进行个性化结果预测.
- 解决预测SCD患者个体HCT成功的知识差距.
主要方法:
- 监督随机森林ML模型被应用到CIBMTR数据集中的1641名接受HCT的SCD患者.
- 特征选择优化了预测变量,包括年龄,并发症指数和HCT前并发症,如血管闭塞危机 (VOC).
- 一个基于网络的工具SPRIGHT被创建用于对整体存活率,移植失败,GVHD和其他结果的个性化预测.
主要成果:
- SPRIGHT在预测结果方面表现出高度的歧视性,曲线下的面积 (AUC) 值在各种事件中从0.67到0.87不等.
- 该模型对大多数结果显示出良好的校准,斜率在0.87-0.96.6之间.
- 在HCT后的VOC (AUC 0.8779) 和移植失败 (AUC 0.8024) 中观察到高度歧视.
结论:
- SPRIGHT 是一个经过验证的基于网络的ML工具,可以预测高差别性SCD患者的HCT后的关键临床结果.
- 该模型包含多个临床相关的HCT前变量,用于个性化风险评估.
- SPRIGHT具有显著的潜力,可以支持临床医生和患者之间关于SCD的HCT的共同决策.
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