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白血病人工智能计划(LEAP)在慢性髓性白血病慢性期:改善患者预后的模型。

The LEukemia Artificial Intelligence Program (LEAP) in chronic myeloid leukemia in chronic phase: A model to improve patient outcomes.

机构信息

Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Am J Hematol. 2021 Feb 1;96(2):241-250. doi: 10.1002/ajh.26047. Epub 2020 Dec 3.

Abstract

Extreme gradient boosting methods outperform conventional machine-learning models. Here, we have developed the LEukemia Artificial intelligence Program (LEAP) with the extreme gradient boosting decision tree method for the optimal treatment recommendation of tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukemia in chronic phase (CML-CP). A cohort of CML-CP patients was randomly divided into training/validation (N = 504) and test cohorts (N = 126). The training/validation cohort was used for 3-fold cross validation to develop the LEAP CML-CP model using 101 variables at diagnosis. The test cohort was then applied to the LEAP CML-CP model and an optimum TKI treatment was suggested for each patient. The area under the curve in the test cohort was 0.81899.Backward multivariate analysis identified age at diagnosis, the degree of comorbidities, and TKI recommended therapy by the LEAP CML-CP model as independent prognostic factors for overall survival. The bootstrapping method internally validated the association of the LEAP CML-CP recommendation with overall survival as an independent prognostic for overall survival. Selecting treatment according to the LEAP CML-CP personalized recommendations, in this model, is associated with better survival probability compared to treatment with a LEAP CML-CP non-recommended therapy. This approach may pave a way of new era of personalized treatment recommendations for patients with cancer.

摘要

极端梯度提升方法优于传统的机器学习模型。在这里,我们开发了 LEukemia 人工智能计划 (LEAP),采用极端梯度提升决策树方法,为慢性髓系白血病慢性期 (CML-CP) 患者的酪氨酸激酶抑制剂 (TKI) 最佳治疗推荐提供支持。一组 CML-CP 患者被随机分为训练/验证 (N = 504) 和测试队列 (N = 126)。使用 101 个诊断时的变量,通过 3 倍交叉验证对训练/验证队列进行了 LEAP CML-CP 模型的开发。然后将测试队列应用于 LEAP CML-CP 模型,并为每个患者建议最佳的 TKI 治疗方案。测试队列的曲线下面积为 0.81899。向后多元分析确定了诊断时的年龄、合并症的严重程度以及 LEAP CML-CP 模型推荐的 TKI 治疗方案是总生存期的独立预后因素。自举法内部验证了 LEAP CML-CP 建议与总生存期之间的关联是总生存期的独立预后因素。根据 LEAP CML-CP 的个性化建议选择治疗方案,与 LEAP CML-CP 非推荐治疗方案相比,与更好的生存概率相关。这种方法可能为癌症患者的个性化治疗建议开辟一个新时代。

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