Artificial intelligence methods to estimate overall mortality and non-relapse mortality following allogeneic HCT in the modern era: an EBMT-TCWP study.

Journal: Bone marrow transplantation
Published Date: Nov 25, 2023

Abstract

Allogeneic haematopoietic cell transplantation (alloHCT) has curative potential counterbalanced by its toxicity. Prognostic scores fail to include current era patients and alternative donors. We examined adult patients from the EBMT registry who underwent alloHCT between 2010 and 2019 for oncohaematological disease. Our primary objective was to develop a new prognostic score for overall mortality (OM), with a secondary objective of predicting non-relapse mortality (NRM) using the OM score. AI techniques were employed. The model for OM was trained, optimized, and validated using 70%, 15%, and 15% of the data set, respectively. The top models, "gradient boosting" for OM (AUC = 0.64) and "elasticnet" for NRM (AUC = 0.62), were selected. The analysis included 33,927 patients. In the final prognostic model, patients with the lowest score had a 2-year OM and NRM of 18 and 13%, respectively, while those with the highest score had a 2-year OM and NRM of 82 and 93%, respectively. The results were consistent in the subset of the haploidentical cohort (n = 4386). Our score effectively stratifies the risk of OM and NRM in the current era but do not significantly improve mortality prediction. Future prognostic scores can benefit from identifying biological or dynamic markers post alloHCT.

Authors

  • A Mussetti
    Department of Haematology, Institut Català d'Oncologia - Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain. amussetti@iconcologia.net.
  • B Rius-Sansalvador
    Biomarkers and Susceptibility Unit (UBS), Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain.
  • V Moreno
    Biomarkers and Susceptibility Unit (UBS), Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain.
  • C Peczynski
    EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital, INSERM Unité Mixte de Recherche (UMR)-S 938, Sorbonne University, Paris, France.
  • E Polge
    EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukaemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France.
  • J E Galimard
    EBMT, Statistics Unit, Paris, France.
  • N Kröger
  • D Blaise
    Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.
  • R Peffault de Latour
    Service d'Hématologie-Greffe, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
  • A Kulagin
    Raisa Memorial (RM) Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia.
  • A Mousavi
    Shariati Hospital, Haematology-Oncology and BMT Research, Tehran, Islamic Republic of Iran.
  • M Stelljes
    Department of Medicine A, University Hospital Münster, Münster, Germany.
  • R M Hamladji
    Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria.
  • J M Middeke
    Med. Klinik I, University Hospital, TU Dresden, Germany.
  • U Salmenniemi
    HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland.
  • H Sengeloev
    Bone Marrow Transplant Unit Copenhagen, Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • E Forcade
    CHU Bordeaux, Service d'hématologie Clinique et Thérapie Cellulaire, 33000, Pessac, France.
  • U Platzbecker
    University Hospital Leipzig, Leipzig, Germany.
  • P Reményi
    Department of Haematology and Stem Cell Transplant, Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet, Budapest, Hungary.
  • E Angelucci
    Haematology and Cellular Therapy Unit. IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • P Chevallier
    CHU Nantes, Nantes, France.
  • I Yakoub-Agha
    CHU de Lille LIRIC, INSERM U995, Université de Lille, Lille, France.
  • C Craddock
    Department of Haematology, University Hospital Birmingham NHS Trust, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, UK.
  • F Ciceri
    Haematology & Bone Marrow Transplant, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • T Schroeder
    Department of Bone Marrow Transplantation, University Hospital, Essen, Germany.
  • M Aljurf
    Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Koenecke Ch
    Hannover Medical School, Hannover, Germany.
  • I Moiseev
    R.M.Gorbacheva Memorial Institute of Oncology, Haematology and Transplantation, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russian Federation.
  • O Penack
    Department of Haematology, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • H Schoemans
    Department of Haematology, University Hospitals Leuven, Leuven, Belgium.
  • M Mohty
    Department of Haematology, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France.
  • B Glass
    Klinik für Hämatologie und Stammzelltransplantation, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
  • A Sureda
    Department of Haematology, Institut Català d'Oncologia - Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain.
  • G Basak
    Department of Haematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
  • Z Peric
    School of medicine, University of Zagreb and University Hospital Centre Zagreb, Zagreb, Croatia.

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