Patient-based prediction algorithm of relapse after allo-HSCT for acute Leukemia and its usefulness in the decision-making process using a machine learning approach.

Journal: Cancer medicine
Published Date: Sep 1, 2019

Abstract

Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for high-risk acute leukemia (AL), some patients still relapse. Since patients simultaneously have many prognostic factors, difficulties are associated with the construction of a patient-based prediction algorithm of relapse. The alternating decision tree (ADTree) is a successful classification method that combines decision trees with the predictive accuracy of boosting. It is a component of machine learning (ML) and has the capacity to simultaneously analyze multiple factors. Using ADTree, we attempted to construct a prediction model of leukemia relapse within 1 year of transplantation. With the model of training data (n = 148), prediction accuracy, the AUC of ROC, and the κ-statistic value were 78.4%, 0.746, and 0.508, respectively. The false positive rate (FPR) of the relapse prediction was as low as 0.134. In an evaluation of the model with validation data (n = 69), prediction accuracy, AUC, and FPR of the relapse prediction were similar at 71.0%, 0.667, and 0.216, respectively. These results suggest that the model is generalized and highly accurate. Furthermore, the output of ADTree may visualize the branch point of treatment. For example, the selection of donor types resulted in different relapse predictions. Therefore, clinicians may change treatment options by referring to the model, thereby improving outcomes. The present results indicate that ML, such as ADTree, will contribute to the decision-making process in the diversified allo-HSCT field and be useful for preventing the relapse of leukemia.

Authors

  • Kyoko Fuse
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Shun Uemura
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Suguru Tamura
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Tatsuya Suwabe
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Takayuki Katagiri
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Tomoyuki Tanaka
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Takashi Ushiki
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Yasuhiko Shibasaki
    Department of Hematopoietic Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan.
  • Naoko Sato
    Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
  • Toshio Yano
    Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
  • Takashi Kuroha
    Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
  • Shigeo Hashimoto
    Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
  • Tatsuo Furukawa
    Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
  • Miwako Narita
    Laboratory of Hematology and Oncology, Graduate School of Health Sciences, Niigata University, Niigata, Japan.
  • Hirohito Sone
    Faculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata University, Niigata, Japan.
  • Masayoshi Masuko
    Department of Hematopoietic Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan.

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