Abstract

Simple SummaryB-cell Acute Lymphoblastic Leukaemia is one of the most common cancers in childhood, with 20% of patients eventually relapsing. Flow cytometry is routinely used for diagnosis and follow-up, but it currently does not provide prognostic value at diagnosis. The volume and the high-dimensional character of this data makes it ideal for its exploitation by means of Artificial Intelligence methods. We collected flow cytometry data from 56 patients from two hospitals. We analysed differences in intensity of marker expression in order to predict relapse at the moment of diagnosis. We finally correlated this data with biomolecular information, constructing a classifier based on CD38 expression.Artificial intelligence methods may help in unveiling information that is hidden in high-dimensional oncological data. Flow cytometry studies of haematological malignancies provide quantitative data with the potential to be used for the construction of response biomarkers. Many computational methods from the bioinformatics toolbox can be applied to these data, but they have not been exploited in their full potential in leukaemias, specifically for the case of childhood B-cell Acute Lymphoblastic Leukaemia. In this paper, we analysed flow cytometry data that were obtained at diagnosis from 56 paediatric B-cell Acute Lymphoblastic Leukaemia patients from two local institutions. Our aim was to assess the prognostic potential of immunophenotypical marker expression intensity. We constructed classifiers that are based on the Fisher’s Ratio to quantify differences between patients with relapsing and non-relapsing disease. We also correlated this with genetic information. The main result that arises from the data was the association between subexpression of marker CD38 and the probability of relapse.

Highlights

  • Acute Lymphoblastic Leukaemia (ALL) is the most common childhood cancer, accounting for 40% of all paediatric neoplasias [1]

  • Statistical differences between the averages of these parameters were found for markers CD38, CD45, and CD33

  • The unprecedented amount and complexity of clinical data that is available nowadays has resulted in the proliferation of bioinformatics pipelines and artificial intelligence algorithms

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Summary

Introduction

Acute Lymphoblastic Leukaemia (ALL) is the most common childhood cancer, accounting for 40% of all paediatric neoplasias [1]. The current treatment protocols yield survival rates of around 80% [3], but the prognosis of relapsing patients is substantially worse [4] These high survival rates are a result of combined progress in therapeutical options and diagnostic methods [5]. With respect to the former, the current options consist of multi-agent chemotherapeutic regimes, which are accompanied by Central Nervous Systems (CNS) preventive therapy and immunosuppressive drugs [6]. With respect to the latter, patients are stratified according to a risk-based scheme and treated . Improving the risk assessment is fundamental for the early identification of relapsing patients

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