EASIX-1year and late mortality after allogeneic stem cell transplantation
Abstract - Patients with hematological malignancies who survive the first year after allogeneic stem cell transplantation (allo-SCT) without relapse have a substantial risk of nonrelapse mortality (NRM) and missing predictive markers. The Endothelial Activation and Stress Index (EASIX) p...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
September 15, 2023
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| In: |
Blood advances
Year: 2023, Volume: 7, Issue: 18, Pages: 5374-5381 |
| ISSN: | 2473-9537 |
| DOI: | 10.1182/bloodadvances.2022008617 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1182/bloodadvances.2022008617 Verlag, lizenzpflichtig, Volltext: https://ashpublications.org/bloodadvances/article/7/18/5374/496948/EASIX-1year-and-late-mortality-after-allogeneic 
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| Author Notes: | Lambros Kordelas, Tobias Terzer, Ted Gooley, Chris Davis, Brenda M. Sandmaier, Mohamed Sorror, Olaf Penack, Nigel D.E. Schaeper, Igor W. Blau, Dietrich Beelen, Aleksandar Radujkovic, Peter Dreger, and Thomas Luft |
| Summary: | Abstract - Patients with hematological malignancies who survive the first year after allogeneic stem cell transplantation (allo-SCT) without relapse have a substantial risk of nonrelapse mortality (NRM) and missing predictive markers. The Endothelial Activation and Stress Index (EASIX) predicts endothelial complications and NRM early after allo-SCT. We hypothesized that EASIX assessed 1 year after allo-SCT in survivors who were disease free may predict late NRM. Survivors who were relapse-free at 1 year after allo-SCT were retrospectively studied in 2 independent cohorts (training cohort, n = 610; merged validation cohort, n = 852). EASIX determined 1 year after allo-SCT correlated with the overall survival (OS), NRM, and relapse. Serum endothelial and inflammatory markers were measured in the training cohort and correlated with EASIX-1year, which predicted OS and NRM but not relapse risk in both the training and validation cohorts in univariable and multivariable Cox regression analyses. Brier score and c-index analyses validated the univariable EASIX effects. There was no significant interaction between EASIX-1year and incidence of chronic graft-versus-host disease (GVHD) on OS. EASIX-1year predicted the outcome irrespective of preexisting comorbidities. Principal causes of NRM in both training and validation cohorts were infections with and without GVHD as well as cardiovascular complications. EASIX-1year correlated with sCD141 and interleukin-18 but not with C-reactive protein, suppressor of tumorigenicity-2, angiopoietin-2, CXCL9, or CXCL8. To our knowledge, EASIX-1year is the first validated predictor of late overall and NRM. Patients who are high risk as defined by EASIX-1year might be considered for intensified surveillance and prophylactic measures. |
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| Item Description: | Gesehen am 08.01.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2473-9537 |
| DOI: | 10.1182/bloodadvances.2022008617 |