A predictive algorithm using clinical and laboratory parameters may assist in ruling out and in diagnosing MDS

We present a noninvasive Web-based app to help exclude or diagnose myelodysplastic syndrome (MDS), a bone marrow (BM) disorder with cytopenias and leukemic risk, diagnosed by BM examination. A sample of 502 MDS patients from the European MDS (EUMDS) registry (n > 2600) was combined with 502 contr...

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Bibliographic Details
Published in:	Blood advances Vol. 5; no. 16; pp. 3066 - 3075
Main Authors:	Oster, Howard S., Crouch, Simon, Smith, Alexandra, Yu, Ge, Abu Shrkihe, Bander, Baruch, Shoham, Kolomansky, Albert, Ben-Ezra, Jonathan, Naor, Shachar, Fenaux, Pierre, Symeonidis, Argiris, Stauder, Reinhard, Cermak, Jaroslav, Sanz, Guillermo, Hellström-Lindberg, Eva, Malcovati, Luca, Langemeijer, Saskia, Germing, Ulrich, Holm, Mette Skov, Madry, Krzysztof, Guerci-Bresler, Agnes, Culligan, Dominic, Sanhes, Laurence, Mills, Juliet, Kotsianidis, Ioannis, van Marrewijk, Corine, Bowen, David, de Witte, Theo, Mittelman, Moshe
Format:	Journal Article
Language:	English
Published:	Washington, DC Elsevier Inc 24.08.2021 American Society of Hematology
Subjects:	Myeloid Neoplasia
ISSN:	2473-9529, 2473-9537, 2473-9537
Online Access:	Get full text
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Summary:	We present a noninvasive Web-based app to help exclude or diagnose myelodysplastic syndrome (MDS), a bone marrow (BM) disorder with cytopenias and leukemic risk, diagnosed by BM examination. A sample of 502 MDS patients from the European MDS (EUMDS) registry (n > 2600) was combined with 502 controls (all BM proven). Gradient-boosted models (GBMs) were used to predict/exclude MDS using demographic, clinical, and laboratory variables. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the models, and performance was validated using 100 times fivefold cross-validation. Model stability was assessed by repeating its fit using different randomly chosen groups of 502 EUMDS cases. AUC was 0.96 (95% confidence interval, 0.95-0.97). MDS is predicted/excluded accurately in 86% of patients with unexplained anemia. A GBM score (range, 0-1) of less than 0.68 (GBM < 0.68) resulted in a negative predictive value of 0.94, that is, MDS was excluded. GBM ≥ 0.82 provided a positive predictive value of 0.88, that is, MDS. The diagnosis of the remaining patients (0.68 ≤ GBM < 0.82) is indeterminate. The discriminating variables: age, sex, hemoglobin, white blood cells, platelets, mean corpuscular volume, neutrophils, monocytes, glucose, and creatinine. A Web-based app was developed; physicians could use it to exclude or predict MDS noninvasively in most patients without a BM examination. Future work will add peripheral blood cytogenetics/genetics, EUMDS-based prospective validation, and prognostication. •A BM examination is the gold standard for the diagnosis of MDS, but it is invasive and subjective.•A predictive algorithm/app using data of 10 readily available parameters from 1004 subjects was developed to help diagnose/rule out MDS. [Display omitted]
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 For data sharing, please contact the corresponding authors, Moshe Mittelman at moshemt@tlvmc.gov.il or Howard S. Oster at howardo@tlvmc.gov.il.
ISSN:	2473-9529 2473-9537 2473-9537
DOI:	10.1182/bloodadvances.2020004055