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Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy

Maintenance chemotherapy with oral 6-mercaptopurine and methotrexate remains a cornerstone of modern therapy for acute lymphoblastic leukaemia. The dosage and intensity of therapy are based on surrogate markers such as peripheral blood leukocyte and neutrophil counts. Dosage based leukocyte count pr...

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Detalles Bibliográficos
Autores principales: Karppinen, Santeri, Lohi, Olli, Vihola, Matti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889389/
https://www.ncbi.nlm.nih.gov/pubmed/31792398
http://dx.doi.org/10.1038/s41598-019-54492-5
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author Karppinen, Santeri
Lohi, Olli
Vihola, Matti
author_facet Karppinen, Santeri
Lohi, Olli
Vihola, Matti
author_sort Karppinen, Santeri
collection PubMed
description Maintenance chemotherapy with oral 6-mercaptopurine and methotrexate remains a cornerstone of modern therapy for acute lymphoblastic leukaemia. The dosage and intensity of therapy are based on surrogate markers such as peripheral blood leukocyte and neutrophil counts. Dosage based leukocyte count predictions could provide support for dosage decisions clinicians face trying to find and maintain an appropriate dosage for the individual patient. We present two Bayesian nonlinear state space models for predicting patient leukocyte counts during the maintenance therapy. The models simplify some aspects of previously proposed models but allow for some extra flexibility. Our second model is an extension which accounts for extra variation in the leukocyte count due to a treatment adversity, infections, using C-reactive protein as a surrogate. The predictive performances of our models are compared against a model from the literature using time series cross-validation with patient data. In our experiments, our simplified models appear more robust and deliver competitive results with the model from the literature.
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spelling pubmed-68893892019-12-10 Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy Karppinen, Santeri Lohi, Olli Vihola, Matti Sci Rep Article Maintenance chemotherapy with oral 6-mercaptopurine and methotrexate remains a cornerstone of modern therapy for acute lymphoblastic leukaemia. The dosage and intensity of therapy are based on surrogate markers such as peripheral blood leukocyte and neutrophil counts. Dosage based leukocyte count predictions could provide support for dosage decisions clinicians face trying to find and maintain an appropriate dosage for the individual patient. We present two Bayesian nonlinear state space models for predicting patient leukocyte counts during the maintenance therapy. The models simplify some aspects of previously proposed models but allow for some extra flexibility. Our second model is an extension which accounts for extra variation in the leukocyte count due to a treatment adversity, infections, using C-reactive protein as a surrogate. The predictive performances of our models are compared against a model from the literature using time series cross-validation with patient data. In our experiments, our simplified models appear more robust and deliver competitive results with the model from the literature. Nature Publishing Group UK 2019-12-02 /pmc/articles/PMC6889389/ /pubmed/31792398 http://dx.doi.org/10.1038/s41598-019-54492-5 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Karppinen, Santeri
Lohi, Olli
Vihola, Matti
Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title_full Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title_fullStr Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title_full_unstemmed Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title_short Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
title_sort prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889389/
https://www.ncbi.nlm.nih.gov/pubmed/31792398
http://dx.doi.org/10.1038/s41598-019-54492-5
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