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MDS DTA Mutational Burden Study

This repository contains the code, SQL queries, and Jupyter notebooks used for the computational analysis of DTA mutational burden (DNMT3A, TET2, ASXL1) as a prognostic biomarker in myelodysplastic syndromes (MDS).
The project evaluates the impact of cumulative mutational burden on overall survival (OS) and leukemia-free survival (LFS) using both traditional survival methods and machine-learning models.


Background

Mutations in DNMT3A, TET2, and ASXL1 (collectively known as DTA) are highly prevalent in:

  • Age-related clonal hematopoiesis (ARCH / CHIP)
  • Myelodysplastic syndromes (MDS)
  • Myeloid neoplasms more broadly

While individual DTA mutations have been associated with CHIP biology and clonal evolution, the prognostic impact of cumulative DTA mutational burden in treatment-naïve MDS has not been fully explored.
This project evaluates whether the number and type of DTA variants contribute additional prognostic information beyond established clinical tools.


Methods Summary

Data Processing

  • SQL-based extraction of clinical, cytogenetic, and genomic features
  • Harmonization of mutation calls across DTA loci
  • Creation of cumulative DTA burden metrics:
    • n_dta (total DTA mutations)
    • gene-specific burden (e.g., n_asxl1, n_dnmt3a)
    • truncating vs. non-truncating subclassification

Statistical Modeling

  • Kaplan–Meier survival analysis
  • Cox proportional hazards models
  • Multiple comparison adjustments (Holm–Bonferroni)
  • Bootstrap confidence intervals for C-index and IBS

Machine Learning Survival Models

  • CoxNet (elastic net penalized Cox regression)
  • Random Survival Forest (RSF)
  • Gradient Boosting Survival Tree (GBST)
  • SHAP explainability for feature attribution

Model Evaluation

  • C-index with 95% bootstrap confidence intervals
  • Integrated Brier Score (IBS) for calibration
  • SHAP-based variable importance for interpretability

Clone the repository

git clone git@github.com:pvhernandezlab/MDS_DTA_mutational_burden_study.git
cd MDS_DTA_mutational_burden_study

Questions

If you have questions or run into any issues, please submit a GitHub issue with details of the cell output

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