Cell Population Data-Driven Acute Promyelocytic Leukemia Flagging Through Artificial Neural Network Predictive Modeling

Rana Zeeshan Haider; Ikram Uddin Ujjan; Tahir S Shamsi

doi:10.1016/j.tranon.2019.09.009

Cell Population Data-Driven Acute Promyelocytic Leukemia Flagging Through Artificial Neural Network Predictive Modeling

Transl Oncol. 2020 Jan;13(1):11-16. doi: 10.1016/j.tranon.2019.09.009. Epub 2019 Nov 13.

Authors

Rana Zeeshan Haider¹, Ikram Uddin Ujjan², Tahir S Shamsi³

Affiliations

¹ Post-graduate Institute of Life Sciences, National Institute of Blood Disease (NIBD), Karachi, Pakistan; International Center for Chemical and Biological Sciences (ICCBS), University of Karachi, Karachi, Pakistan. Electronic address: zeeshan3335@yahoo.com.
² Department of Basic Medical Sciences, Liaqat University of Health and Medical Sciences (LUMHS), Jamshoro, Pakistan.
³ Post-graduate Institute of Life Sciences, National Institute of Blood Disease (NIBD), Karachi, Pakistan.

Abstract

A targeted and timely offered treatment can be a benefitting tool for patients with acute promyelocytic leukemia (APML). Current round of study made use of potential morphological and immature fraction-related parameters (cell population data) generated during complete blood cell count (CBC), through artificial neural network (ANN) predictive modeling for early flagging of APML cases. We collected classical CBC items along with cell population data (CPD) from hematology analyzer at diagnosis of 1067 study subjects with hematological neoplasms. For morphological assessment, peripheral blood films were examined. Statistical and machine learning tools including principal component analysis (PCA) helped in the evaluation of predictive capacity of routine and CPD items. Then selected CBC item-driven ANN predictive modeling was developed to smartly use the hidden trend by increasing the auguring accuracy of these parameters in differentiation of APML cases. We found a characteristic triad based on lower (53.73) platelet count (PLT) with decreased/normal (4.72) immature fraction of platelet (IPF) with addition of significantly higher value (65.5) of DNA/RNA content-related neutrophil (NE-SFL) parameter in patients with APML against other hematological neoplasm's groups. On PCA, APML showed exceptionally significant variance for PLT, IPF, and NE-SFL. Through training of ANN predictive modeling, our selected CBC items successfully classify the APML group from non-APML groups at highly significant (0.894) AUC value with lower (2.3 percent) false prediction rate. Practical results of using our ANN model were found acceptable with value of 95.7% and 97.7% for training and testing data sets, respectively. We proposed that PLT, IPF, and NE-SFL could potentially be used for early flagging of APML cases in the hematology-oncology unit. CBC item-driven ANN modeling is a novel approach that substantially strengthen the predictive potential of CBC items, allowing the clinicians to be confident by the typical trend raised by these studied parameters.