Wang et al reported an immune risk score for predicting survival of a patient with acute myeloid leukemia (AML) who is receiving chemotherapy. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in China and Europe.
Patient selection: acute myeloid leukemia (AML)
Analysis: relative proportion of 22 human immune-related cell subsets in the gene expression profile
Parameters:
(1) proportion of activated NK cells
(2) proportion of naive B cells
(3) proportion of resting mast cells
(4) proportion of CD8-positive T cells
(5) proportion of M2 macrophages
(6) proportion of follicular helper T cells
Parameter
|
Points
|
proportion of activated NK cells
|
4.24 * (proportion activated NK cells)
|
proportion of naive B cells
|
2.01 * (proportion naive B cells)
|
proportion of resting mast cells
|
-0.41 * (proportion resting mast cells)
|
proportion of CD8 positive T cells
|
-0.8 * (proportion CD8 positive T cells)
|
proportion of M2 macrophages
|
- 1 * (proportion M2 macrophages)
|
proportion of follicular helper T cells
|
-2.87 * (proportion FH T cells)
|
risk score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -5.08 (assuming that proportions are decimal fractions from 0 to 1)
• maximum score: 6.25
• According to the accompanying nomogram, most scores fall in the range of -1.4 to 1.
• The score was divided into low and high risk groups, with the cutoff varying between cohorts.
Performance:
• The area under the ROC curve for 5-year survival was 0.68 in the training cohort.