{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:56:32Z","timestamp":1790679392816,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Allogeneic hematopoietic stem cell transplantation (allo\u2010HSCT) is a curative treatment option for a significant proportion of patients with acute myeloid leukemia (AML), and it is generally recommended when the relapse risk without allo\u2010HSCT outweighs the estimated non\u2010relapse mortality significantly. While current recommendations for allo\u2010HSCT are based on risk groups, there is considerable heterogeneity within these individual categories. We analyzed 2550 intensively treated AML patients aged 18\u201370 with cytogenetic and next\u2010generation sequencing data from the HARMONY Alliance database, who did not receive allo\u2010HSCT in first complete remission (CR1). A non\u2010parametric machine learning (ML) model based on Bayesian Additive Regression Trees (BART) integrated clinical variables and genomic aberrations to provide individualized outcome estimations. External validation was performed in a cohort of 714 patients enrolled in UK\u2010NCRI trials. The predictive performance of the HARMONY ML model, measured by the area under the time\u2010dependent receiver operating curve (AUC(t)), was superior to European LeukemiaNet (ELN)2022 risk classification in estimating 5\u2010year overall survival (0.741 vs. 0.700), 5\u2010year relapse\u2010free survival (0.752 vs. 0.705), and 5\u2010year cumulative incidence of relapse (0.742 vs. 0.708), which was confirmed in the external validation cohort. Notably, the model revealed substantial heterogeneity within ELN2022 risk groups, identifying a significant proportion of favorable\u2010risk patients with a predicted 5\u2010year CIR\u2009&gt;\u200940%, who could potentially benefit from allo\u2010HSCT in CR1. The HARMONY ML model provides individualized risk prediction in intensively treated adult AML patients and supports more tailored therapeutic decisions regarding allo\u2010HSCT in CR1, which should be further advanced by integrating measurable residual disease in the future.<\/jats:p>","DOI":"10.1002\/hem3.70461","type":"journal-article","created":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T11:37:31Z","timestamp":1788089851000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Machine learning provides individualized prediction of outcomes after first complete remission without allo\u2010HSCT consolidation in adult acute myeloid leukemia\u2014A HARMONY study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-3096","authenticated-orcid":false,"given":"Alberto","family":"Hern\u00e1ndez\u2010S\u00e1nchez","sequence":"first","affiliation":[{"name":"Hematology Department University Hospital of Salamanca Salamanca Spain"},{"name":"Institute of Biomedical Research of Salamanca (IBSAL) Salamanca Spain"},{"name":"Cancer Research Center of Salamanca (USAL\u2010CSIC) Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mart\u00ednez Elicegui","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL) Salamanca Spain"},{"name":"Cancer Research Center of Salamanca (USAL\u2010CSIC) Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Str\u00e4ng","sequence":"additional","affiliation":[{"name":"Charit\u00e9 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Benner","sequence":"additional","affiliation":[{"name":"Division of Biostatistics German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Sobas","sequence":"additional","affiliation":[{"name":"Department of Hematology, Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toru\u0144 Bydgoszcz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Villaverde Ramiro","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL) Salamanca Spain"},{"name":"Cancer Research Center of Salamanca (USAL\u2010CSIC) Salamanca Spain"},{"name":"HARMONY Alliance Foundation Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin T.","family":"Turki","sequence":"additional","affiliation":[{"name":"Marienhospital University Hospital Ruhr\u2010University Bochum Bochum Germany"},{"name":"Institute for AI in Medicine University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Ab\u00e1igar","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL) Salamanca Spain"},{"name":"Cancer Research Center of Salamanca (USAL\u2010CSIC) Salamanca Spain"},{"name":"HARMONY Alliance Foundation Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gastone","family":"Castellani","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurjen","family":"Versluis","sequence":"additional","affiliation":[{"name":"Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Thomas","sequence":"additional","affiliation":[{"name":"Centre for Trials Research Cardiff University Cardiff United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse M.","family":"Tettero","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC Location VUMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabea","family":"Mecklenbrauck","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation Hannover Medical School Hannover Germany"},{"name":"Weatherall Institute of Molecular Medicine University of Oxford Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Mart\u00ednez\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pratcorona","sequence":"additional","affiliation":[{"name":"Hematology Hospital de la Santa Creu i Sant Pau Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Sanz","sequence":"additional","affiliation":[{"name":"CIBERONC, Instituto de Salud Carlos III Madrid Spain"},{"name":"Hospital Universitario y Polit\u00e9cnico La Fe Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Voso","sequence":"additional","affiliation":[{"name":"University of Rome Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Uppsala University Hospital Uppsala Sweden"},{"name":"Department of Medicine Huddinge, Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"R\u00f6llig","sequence":"additional","affiliation":[{"name":"Medical Department I University Hospital TU Dresden Dresden 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