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Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia

Background: The International Prognostic Index (IPI) is applied to predict the outcome of chronic lymphocytic leukemia (CLL) with five prognostic factors, including genetic analysis. We investigated whether multiparameter flow cytometry (MPFC) data of CLL samples could predict the outcome by methods...

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Autores principales: Hoffmann, Joerg, Eminovic, Semil, Wilhelm, Christian, Krause, Stefan W., Neubauer, Andreas, Thrun, Michael C., Ultsch, Alfred, Brendel, Cornelia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955184/
https://www.ncbi.nlm.nih.gov/pubmed/36826109
http://dx.doi.org/10.3390/curroncol30020148
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author Hoffmann, Joerg
Eminovic, Semil
Wilhelm, Christian
Krause, Stefan W.
Neubauer, Andreas
Thrun, Michael C.
Ultsch, Alfred
Brendel, Cornelia
author_facet Hoffmann, Joerg
Eminovic, Semil
Wilhelm, Christian
Krause, Stefan W.
Neubauer, Andreas
Thrun, Michael C.
Ultsch, Alfred
Brendel, Cornelia
author_sort Hoffmann, Joerg
collection PubMed
description Background: The International Prognostic Index (IPI) is applied to predict the outcome of chronic lymphocytic leukemia (CLL) with five prognostic factors, including genetic analysis. We investigated whether multiparameter flow cytometry (MPFC) data of CLL samples could predict the outcome by methods of explainable artificial intelligence (XAI). Further, XAI should explain the results based on distinctive cell populations in MPFC dot plots. Methods: We analyzed MPFC data from the peripheral blood of 157 patients with CLL. The ALPODS XAI algorithm was used to identify cell populations that were predictive of inferior outcomes (death, failure of first-line treatment). The diagnostic ability of each XAI population was evaluated with receiver operating characteristic (ROC) curves. Results: ALPODS defined 17 populations with higher ability than the CLL-IPI to classify clinical outcomes (ROC: area under curve (AUC) 0.95 vs. 0.78). The best single classifier was an XAI population consisting of CD4+ T cells (AUC 0.78; 95% CI 0.70–0.86; p < 0.0001). Patients with low CD4+ T cells had an inferior outcome. The addition of the CD4+ T-cell population enhanced the predictive ability of the CLL-IPI (AUC 0.83; 95% CI 0.77–0.90; p < 0.0001). Conclusions: The ALPODS XAI algorithm detected highly predictive cell populations in CLL that may be able to refine conventional prognostic scores such as IPI.
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spelling pubmed-99551842023-02-25 Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia Hoffmann, Joerg Eminovic, Semil Wilhelm, Christian Krause, Stefan W. Neubauer, Andreas Thrun, Michael C. Ultsch, Alfred Brendel, Cornelia Curr Oncol Article Background: The International Prognostic Index (IPI) is applied to predict the outcome of chronic lymphocytic leukemia (CLL) with five prognostic factors, including genetic analysis. We investigated whether multiparameter flow cytometry (MPFC) data of CLL samples could predict the outcome by methods of explainable artificial intelligence (XAI). Further, XAI should explain the results based on distinctive cell populations in MPFC dot plots. Methods: We analyzed MPFC data from the peripheral blood of 157 patients with CLL. The ALPODS XAI algorithm was used to identify cell populations that were predictive of inferior outcomes (death, failure of first-line treatment). The diagnostic ability of each XAI population was evaluated with receiver operating characteristic (ROC) curves. Results: ALPODS defined 17 populations with higher ability than the CLL-IPI to classify clinical outcomes (ROC: area under curve (AUC) 0.95 vs. 0.78). The best single classifier was an XAI population consisting of CD4+ T cells (AUC 0.78; 95% CI 0.70–0.86; p < 0.0001). Patients with low CD4+ T cells had an inferior outcome. The addition of the CD4+ T-cell population enhanced the predictive ability of the CLL-IPI (AUC 0.83; 95% CI 0.77–0.90; p < 0.0001). Conclusions: The ALPODS XAI algorithm detected highly predictive cell populations in CLL that may be able to refine conventional prognostic scores such as IPI. MDPI 2023-02-04 /pmc/articles/PMC9955184/ /pubmed/36826109 http://dx.doi.org/10.3390/curroncol30020148 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hoffmann, Joerg
Eminovic, Semil
Wilhelm, Christian
Krause, Stefan W.
Neubauer, Andreas
Thrun, Michael C.
Ultsch, Alfred
Brendel, Cornelia
Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title_full Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title_fullStr Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title_full_unstemmed Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title_short Prediction of Clinical Outcomes with Explainable Artificial Intelligence in Patients with Chronic Lymphocytic Leukemia
title_sort prediction of clinical outcomes with explainable artificial intelligence in patients with chronic lymphocytic leukemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955184/
https://www.ncbi.nlm.nih.gov/pubmed/36826109
http://dx.doi.org/10.3390/curroncol30020148
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