论文标题

机器学习策略以预测儿童急性淋巴细胞白血病幸存者的晚期不良影响

Machine learning strategies to predict late adverse effects in childhood acute lymphoblastic leukemia survivors

论文作者

Raymond, Nicolas, Caru, Maxime, Laribi, Hakima, Mitiche, Mehdi, Marcil, Valérie, Krajinovic, Maja, Curnier, Daniel, Sinnett, Daniel, Vallières, Martin

论文摘要

急性淋巴细胞白血病是最常见的小儿癌。大约三分之一的幸存者会在治疗后形成一种或多种健康并发症,称为后期不良反应。在患者对医院的随访期间提供的现有措施是所有儿童癌症幸存者的标准化,而不一定针对儿童时期所有幸存者。结果,晚期不良反应可能被诊断不足,在大多数情况下,只能照顾其外观。因此,必须尽早预测这些与治疗相关的疾病,以防止它们并增强幸存者的健康。多项研究研究了晚期不良反应预测工具的开发,以提供更好的个性化后续方法。但是,迄今为止,尚无解决方案整合神经网络的用法。在这项工作中,我们开发了基于图的参数有效的神经网络,并通过多次事后分析促进了它们的解释性。我们首先提出了一种新的疾病特异性vo $ _2 $峰值预测模型,该模型不需要患者参加身体功能测试(例如6分钟的步行测试),并使用临床变量从儿童期结束时获得所有治疗以及基因组变量,并进一步创建了肥胖预测模型。我们的解决方案能够在两项任务上的一小部分患者($ \ leq $ 223)上获得线性和基于树的模型的性能。

Acute lymphoblastic leukemia is the most frequent pediatric cancer. Approximately two third of survivors develop one or more health complications known as late adverse effects following their treatments. The existing measures offered to patients during their follow-up visits to the hospital are rather standardized for all childhood cancer survivors and not necessarily personalized for childhood ALL survivors. As a result, late adverse effects may be underdiagnosed and, in most cases, only taken care of following their appearance. Thus, it is necessary to predict these treatment-related conditions earlier in order to prevent them and enhance the survivors' health. Multiple studies have investigated the development of late adverse effects prediction tools to offer better personalized follow-up methods. However, no solution integrated the usage of neural networks to date. In this work, we developed graph-based parameters-efficient neural networks and promoted their interpretability with multiple post-hoc analyses. We first proposed a new disease-specific VO$_2$ peak prediction model that does not require patients to participate to a physical function test (e.g., 6-minute walk test) and further created an obesity prediction model using clinical variables that are available from the end of childhood ALL treatment as well as genomic variables. Our solutions were able to achieve better performance than linear and tree-based models on small cohorts of patients ($\leq$ 223) for both tasks.

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