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

Bone Marrow Transplantation volume 59, pages 232–238 (2024)Cite this article

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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.

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Fig. 1: Overall mortality and non-relapse mortality of the whole cohort.
Fig. 2: Receiving operator curve (ROC) for overall mortality.
Fig. 3: Overall mortality stratification.

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The study data belong to the EBMT and may be requested through previous authorization.

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Author information

Author notes

  1. These authors contributed equally: A. Mussetti, B. Rius-Sansalvador.

Authors and Affiliations

  1. Department of Haematology, Institut Català d’Oncologia - Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain

    A. Mussetti & A. Sureda

  2. Biomarkers and Susceptibility Unit (UBS), Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L’Hospitalet del Llobregat, Barcelona, Spain

    B. Rius-Sansalvador & V. Moreno

  3. ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain

    B. Rius-Sansalvador & V. Moreno

  4. EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital, INSERM Unité Mixte de Recherche (UMR)-S 938, Sorbonne University, Paris, France

    C. Peczynski

  5. EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukaemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France

    E. Polge

  6. EBMT, Statistics Unit, Paris, France

    J. E. Galimard

  7. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    N. Kröger

  8. Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

    D. Blaise

  9. Service d’Hématologie-Greffe, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France

    R. Peffault de Latour

  10. Université Paris Diderot, Institut Universitaire d’Hématologie, Sorbonne Paris Cité, Paris, France

    R. Peffault de Latour

  11. Raisa Memorial (RM) Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia

    A. Kulagin

  12. Shariati Hospital, Haematology-Oncology and BMT Research, Tehran, Islamic Republic of Iran

    A. Mousavi

  13. Department of Medicine A, University Hospital Münster, Münster, Germany

    M. Stelljes

  14. Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria

    R. M. Hamladji

  15. Med. Klinik I, University Hospital, TU Dresden, Germany

    J. M. Middeke

  16. HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland

    U. Salmenniemi

  17. Bone Marrow Transplant Unit Copenhagen, Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    H. Sengeloev

  18. CHU Bordeaux, Service d’hématologie Clinique et Thérapie Cellulaire, 33000, Pessac, France

    E. Forcade

  19. University Hospital Leipzig, Leipzig, Germany

    U. Platzbecker

  20. Department of Haematology and Stem Cell Transplant, Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet, Budapest, Hungary

    P. Reményi

  21. Haematology and Cellular Therapy Unit. IRCCS Ospedale Policlinico San Martino, Genova, Italy

    E. Angelucci

  22. CHU Nantes, Nantes, France

    P. Chevallier

  23. CHU de Lille LIRIC, INSERM U995, Université de Lille, Lille, France

    I. Yakoub-Agha

  24. Department of Haematology, University Hospital Birmingham NHS Trust, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, UK

    C. Craddock

  25. Haematology & Bone Marrow Transplant, IRCCS San Raffaele Scientific Institute, Milan, Italy

    F. Ciceri

  26. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    T. Schroeder

  27. Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    M. Aljurf

  28. Hannover Medical School, Hannover, Germany

    Koenecke Ch

  29. R.M.Gorbacheva Memorial Institute of Oncology, Haematology and Transplantation, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russian Federation

    I. Moiseev

  30. Department of Haematology, Charité Universitätsmedizin Berlin, Berlin, Germany

    O. Penack

  31. Department of Haematology, University Hospitals Leuven, Leuven, Belgium

    H. Schoemans

  32. Department of Public Health and Primary Care, ACCENT VV, KU Leuven - University of Leuven, Leuven, Belgium

    H. Schoemans

  33. Department of Haematology, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France

    M. Mohty

  34. Klinik für Hämatologie und Stammzelltransplantation, HELIOS Klinikum Berlin-Buch, Berlin, Germany

    B. Glass

  35. Department of Haematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland

    G. Basak

  36. School of medicine, University of Zagreb and University Hospital Centre Zagreb, Zagreb, Croatia

    Z. Peric

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  1. A. Mussetti
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Contributions

MA, RSB, SA were responsible for the overall research questions and design of the study. RSB, MV, GJE performed the statistical analyses. MA, RSB wrote the original draft. PC, GJE, PE, KN, BD, PLR, KA, MA, SM, HRM, BM, SU, SH, FE, PU, RP, AE, CP, YAI, CC, CF, ST, AM, KC, MI, PO, SH, MM, GB, BG, PZ reviewed and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to A. Mussetti.

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Mussetti, A., Rius-Sansalvador, B., Moreno, V. et al. Artificial intelligence methods to estimate overall mortality and non-relapse mortality following allogeneic HCT in the modern era: an EBMT-TCWP study. Bone Marrow Transplant 59, 232–238 (2024). https://doi.org/10.1038/s41409-023-02147-5

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