Identifying the optimal conditioning intensity for stem cell transplantation in patients with myelodysplastic syndrome: a machine learning analysis

Yoshimitsu Shimomura, Sho Komukai, Tetsuhisa Kitamura, Tomotaka Sobue, Shuhei Kurosawa, Noriko Doki, Yuta Katayama, Yukiyasu Ozawa, Ken ichi Matsuoka, Takashi Tanaka, Shinichi Kako, Masashi Sawa, Yoshinobu Kanda, Hirohisa Nakamae, Hideyuki Nakazawa, Yasunori Ueda, Junya Kanda, Takahiro Fukuda, Yoshiko Atsuta, Ken Ishiyama

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

A conditioning regimen is an essential prerequisite of allogeneic hematopoietic stem cell transplantation for patients with myelodysplastic syndrome (MDS). However, the optimal conditioning intensity for a patient may be difficult to establish. This study aimed to identify optimal conditioning intensity (reduced-intensity conditioning regimen [RIC] or myeloablative conditioning regimen [MAC]) for patients with MDS. Overall, 2567 patients with MDS who received their first HCT between 2009 and 2019 were retrospectively analyzed. They were divided into a training cohort and a validation cohort. Using a machine learning-based model, we developed a benefit score for RIC in the training cohort. The validation cohort was divided into a high-score and a low-score group, based on the median benefit score. The endpoint was progression-free survival (PFS). The benefit score for RIC was developed from nine baseline variables in the training cohort. In the validation cohort, the hazard ratios of the PFS in the RIC group compared to the MAC group were 0.65 (95% confidence interval [CI]: 0.48–0.90, P = 0.009) in the high-score group and 1.36 (95% CI: 1.06–1.75, P = 0.017) in the low-score group (P for interaction < 0.001). Machine-learning-based scoring can be useful for the identification of optimal conditioning regimens for patients with MDS.

Original languageEnglish
Pages (from-to)186-194
Number of pages9
JournalBone Marrow Transplantation
Volume58
Issue number2
DOIs
Publication statusPublished - Feb 2023
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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