Longitudinal clinical data improve survival prediction after hematopoietic cell transplantation using machine learning Journal Article
| Authors: | Zhou, Y.; Smith, J.; Keerthi, D.; Li, C.; Sun, Y.; Mothi, S. S.; Shyr, D. C.; Spitzer, B.; Harris, A.; Chatterjee, A.; Chatterjee, S.; Shouval, R.; Naik, S.; Bertaina, A.; Boelens, J. J.; Triplett, B. M.; Tang, L.; Sharma, A. |
| Article Title: | Longitudinal clinical data improve survival prediction after hematopoietic cell transplantation using machine learning |
| Abstract: | Serial prognostic evaluation after allogeneic hematopoietic cell transplantation (allo-HCT) might help identify patients at high risk of lethal organ dysfunction. Current prediction algorithms based on models that do not incorporate changes to patients’ clinical condition after allo-HCT have limited predictive ability. We developed and validated a robust risk-prediction algorithm to predict short- and long-term survival after allo-HCT in pediatric patients that includes baseline biological variables and changes in the patients’ clinical status after allo-HCT. The model was developed using clinical data from children and young adults treated at a single academic quaternary-care referral center. The model was created using a randomly split training data set (70% of the cohort), internally validated (remaining 30% of the cohort) and then externally validated on patient data from another tertiary-care referral center. Repeated clinical measurements performed from 30 days before allo-HCT to 30 days afterwards were extracted from the electronic medical record and incorporated into the model to predict survival at 100 days, 1 year, and 2 years after allo-HCT. Naïve-Bayes machine learning models incorporating longitudinal data were significantly better than models constructed from baseline variables alone at predicting whether patients would be alive or deceased at the given time points. This proof-of-concept study demonstrates that unlike traditional prognostic tools that use fixed variables for risk assessment, incorporating dynamic variability using clinical and laboratory data improves the prediction of mortality in patients undergoing allo-HCT. © 2024 by The American Society of Hematology. |
| Keywords: | adult; cancer survival; child; leukemia; young adult; major clinical study; overall survival; validation process; bayesian learning; cohort analysis; hematopoietic stem cell transplantation; chronic myeloid leukemia; prediction; acute lymphoblastic leukemia; electronic medical record; myelodysplastic syndrome; algorithm; allogeneic hematopoietic stem cell transplantation; acute myeloid leukemia; machine learning; human; male; female; article; tertiary care center |
| Journal Title: | Blood Advances |
| Volume: | 8 |
| Issue: | 3 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2024-02-13 |
| Start Page: | 686 |
| End Page: | 698 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2023011752 |
| PUBMED: | 37991991 |
| PROVIDER: | scopus |
| PMCID: | PMC10844815 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work