Machine learning predicts stem cell transplant response in severe scleroderma

作者：Jennifer M. Franks, Viktor Martyanov, Yue Wang, Tammara Wood, Ashley Pinckney, Leslie J. Crofford, Lynette Keyes-Elstein, Daniel E. Furst, Ellen Goldmuntz, Maureen D. Mayes, Peter A. McSweeney, Richard A. Nash, Keith M. Sullivan, Michael L. Whitfield · 发表于：Annals of the Rheumatic Diseases · 年份：2020 · DOI：10.1136/annrheumdis-2020-217033 · 被引用次数：43 · 研究领域：Systemic Sclerosis and Related Diseases、Multiple Sclerosis Research Studies、Hematopoietic Stem Cell Transplantation

OBJECTIVE: The Scleroderma: Cyclophosphamide or Transplantation (SCOT) trial demonstrated clinical benefit of haematopoietic stem cell transplant (HSCT) compared with cyclophosphamide (CYC). We mapped PBC (peripheral blood cell) samples from the SCOT clinical trial to scleroderma intrinsic subsets and tested the hypothesis that they predict long-term response to HSCT. METHODS: We analysed gene expression from PBCs of SCOT participants to identify differential treatment response. PBC gene expression data were generated from 63 SCOT participants at baseline and follow-up timepoints. Participants who completed treatment protocol were stratified by intrinsic gene expression subsets at baseline, evaluated for event-free survival (EFS) and analysed for differentially expressed genes (DEGs). RESULTS: Participants from the fibroproliferative subset on HSCT experienced significant improvement in EFS compared with fibroproliferative participants on CYC (p=0.0091). In contrast, EFS did not significantly differ between CYC and HSCT arms for the participants from the normal-like subset (p=0.77) or the inflammatory subset (p=0.1). At each timepoint, we observed considerably more DEGs in HSCT arm compared with CYC arm with HSCT arm showing significant changes in immune response pathways. CONCLUSIONS: Participants from the fibroproliferative subset showed the most significant long-term benefit from HSCT compared with CYC. This study suggests that intrinsic subset stratification of patients m...