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Endothelial Activation and Stress Index (EASIX) to predict mortality after allogeneic stem cell transplantation: a prospective study

Background We previously reported that the “Endothelial Activation and Stress Index” (EASIX; ((creatinine×lactate dehydrogenase)÷thrombocytes)) measured before start of conditioning predicts mortality after allogeneic hematopoietic stem cell transplantation (alloSCT) when used as continuous score. F...

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Main Authors: Penack, Olaf (Author) , Luft, Thomas (Author) , Peczynski, Christophe (Author) , Benner, Axel (Author) , Sica, Simona (Author) , Arat, Mutlu (Author) , Itäla-Remes, Maija (Author) , Corral, Lucia López (Author) , Schaap, Nicolaas P. M. (Author) , Karas, Michal (Author) , Raida, Ludek (Author) , Schroeder, Thomas (Author) , Dreger, Peter (Author) , Metafuni, Elisabetta (Author) , Ozcelik, Tulay (Author) , Sandmaier, Brenda M. (Author) , Kordelas, Lambros (Author) , Moiseev, Ivan (Author) , Schoemans, Hélène (Author) , Könecke, Christian (Author) , Basak, Grzegorz W. (Author) , Peric, Zinaida (Author)
Format: Article (Journal)
Language:English
Published: January 9, 2024.
In: Journal for ImmunoTherapy of Cancer
Year: 2024, Volume: 12, Issue: 1, Pages: 1-8
ISSN:2051-1426
DOI:10.1136/jitc-2023-007635
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1136/jitc-2023-007635
Verlag, kostenfrei, Volltext: https://jitc.bmj.com/content/12/1/e007635
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Author Notes:Olaf Penack, Thomas Luft, Christophe Peczynski, Axel Benner, Simona Sica, Mutlu Arat, Maija Itäla-Remes, Lucia López Corral, Nicolaas P. M. Schaap, Michal Karas, Ludek Raida, Thomas Schroeder, Peter Dreger, Elisabetta Metafuni, Tulay Ozcelik, Brenda M. Sandmaier, Lambros Kordelas, Ivan Moiseev, Hélène Schoemans, Christian Koenecke, Grzegorz W. Basak, Zinaida Peric
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Summary:Background We previously reported that the “Endothelial Activation and Stress Index” (EASIX; ((creatinine×lactate dehydrogenase)÷thrombocytes)) measured before start of conditioning predicts mortality after allogeneic hematopoietic stem cell transplantation (alloSCT) when used as continuous score. For broad clinical implementation, a prospectively validated EASIX-pre cut-off is needed that defines a high-risk cohort and is easy to use. - Method In the current study, we first performed a retrospective cohort analysis in n=2022 alloSCT recipients and identified an optimal cut-off for predicting non-relapse mortality (NRM) as EASIX-pre=3. For cut-off validation, we conducted a multicenter prospective study with inclusion of n=317 first alloSCTs from peripheral blood stem cell in adult patients with acute leukemia, lymphoma or myelodysplastic syndrome/myeloproliferative neoplasms in the European Society for Blood and Marrow Transplantation network. - Results Twenty-three % (n=74) of alloSCT recipients had EASIX-pre ≥3 taken before conditioning. NRM at 2 years was 31.1% in the high EASIX group versus 11.5% in the low EASIX group (p<0.001). Patients with high EASIX-pre also had worse 2 years overall survival (51.6% vs 70.9%; p=0.002). We were able to validate the cut-off and found that EASIX ≥3 was associated with more than twofold increased risk for NRM in multivariate analysis (HR=2.18, 95% CI 1.2 to 3.94; p=0.01). No statistically significant difference could be observed for the incidence of relapse. - Conclusions The results of this study provide a prospectively validated standard laboratory biomarker index to estimate the transplant-related mortality risk after alloSCT. EASIX ≥3 taken before conditioning identifies a population of alloSCT recipients who have a more than twofold increased risk of treatment-related mortality.
Item Description:Gesehen am 12.02.2025
Physical Description:Online Resource
ISSN:2051-1426
DOI:10.1136/jitc-2023-007635

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