EASIX and Mortality After Allogeneic Stem Cell Transplantation

Overview

Journal Bone Marrow Transplant

Specialty General Surgery

Date 2019 Sep 28

PMID 31558788

Citations 54

Authors

Thomas Luft

Axel Benner

Tobias Terzer

Sonata Jodele

Christopher E Dandoy

Rainer Storb

Lambros Kordelas

Dietrich Beelen

Ted Gooley

Brenda M Sandmaier

Mohamed Sorror

Markus Zeisbrich

Aleksandar Radujkovic

Peter Dreger

Olaf Penack

Affiliations

Soon will be listed here.

Abstract

Allogeneic stem cell transplantation (alloSCT) is an effective immunotherapy in patients with hematological malignancies. Endothelial dysfunction was linked to major complications after alloSCT. We asked the question if the "Endothelial Activation and Stress Index" (EASIX; [(creatinine × LDH) ÷ thrombocytes]) can predict mortality after alloSCT. We performed a retrospective cohort analysis in five alloSCT centers in the USA and Germany. EASIX was assessed prior to conditioning (EASIX-pre) and correlated with mortality in 755 patients of a training cohort in multivariable models. The predictive model established in the training cohort was validated in 1267 adult allo-recipients. Increasing EASIX-pre predicted lower overall survival (OS) after alloSCT, and successful model validation was achieved for the validation cohort. We found that EASIX-pre predicts OS irrespective of established scores. Moreover, EASIX-pre was also a significant prognostic factor for transplant-associated microangiopathy. Finally, EASIX-pre correlated with biomarkers of endothelial homeostasis such as CXCL8, interleukin-18, and insulin-like-growth-factor-1 serum levels. This study establishes EASIX-pre based on a standard laboratory biomarker panel as a predictor of individual risk of mortality after alloSCT independently from established clinical criteria.

Citing Articles

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The EASIX score as a predictor of sinusoidal obstruction syndrome and nonrelapse mortality in paediatric patients receiving allogeneic haematopoietic stem cell transplantation.

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