Department of Hematology and Oncology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
School of Life Sciences, Fudan University, Shanghai, China.
J Cell Mol Med. 2020 Apr;24(8):4510-4523. doi: 10.1111/jcmm.15109. Epub 2020 Mar 9.
Acute myeloid leukaemia (AML) is the most common type of adult acute leukaemia and has a poor prognosis. Thus, optimal risk stratification is of greatest importance for reasonable choice of treatment and prognostic evaluation. For our study, a total of 1707 samples of AML patients from three public databases were divided into meta-training, meta-testing and validation sets. The meta-training set was used to build risk prediction model, and the other four data sets were employed for validation. By log-rank test and univariate COX regression analysis as well as LASSO-COX, AML patients were divided into high-risk and low-risk groups based on AML risk score (AMLRS) which was constituted by 10 survival-related genes. In meta-training, meta-testing and validation sets, the patient in the low-risk group all had a significantly longer OS (overall survival) than those in the high-risk group (P < .001), and the area under ROC curve (AUC) by time-dependent ROC was 0.5854-0.7905 for 1 year, 0.6652-0.8066 for 3 years and 0.6622-0.8034 for 5 years. Multivariate COX regression analysis indicated that AMLRS was an independent prognostic factor in four data sets. Nomogram combining the AMLRS and two clinical parameters performed well in predicting 1-year, 3-year and 5-year OS. Finally, we created a web-based prognostic model to predict the prognosis of AML patients (https://tcgi.shinyapps.io/amlrs_nomogram/).
急性髓系白血病(AML)是成人急性白血病中最常见的类型,预后较差。因此,最佳风险分层对于合理选择治疗方法和预后评估至关重要。在我们的研究中,从三个公共数据库中总共收集了 1707 例 AML 患者的样本,将其分为荟萃训练、荟萃测试和验证集。荟萃训练集用于构建风险预测模型,其余四个数据集用于验证。通过对数秩检验、单变量 COX 回归分析以及 LASSO-COX,根据 AML 风险评分(AMLRS)将 AML 患者分为高风险和低风险组,AMLRS 由 10 个与生存相关的基因组成。在荟萃训练、荟萃测试和验证集中,低风险组患者的 OS(总生存期)均明显长于高风险组患者(P<.001),并且时间依赖性 ROC 曲线下的 AUC 分别为 1 年时的 0.5854-0.7905、3 年时的 0.6652-0.8066 和 5 年时的 0.6622-0.8034。多变量 COX 回归分析表明,AMLRS 是四个数据集中的独立预后因素。结合 AMLRS 和两个临床参数的列线图在预测 1 年、3 年和 5 年 OS 方面表现良好。最后,我们创建了一个基于网络的预测模型来预测 AML 患者的预后(https://tcgi.shinyapps.io/amlrs_nomogram/)。