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

O. Penack, T. Luft, C. Peczynski, A. Benner, S. Sica, M. Arat, M. Itäla-Remes, LL. Corral, NPM. Schaap, M. Karas, L. Raida, T. Schroeder, P. Dreger, E. Metafuni, T. Ozcelik, BM. Sandmaier, L. Kordelas, I. Moiseev, H. Schoemans, C. Koenecke, GW....

. 2024 ; 12 (1) : . [pub] 20240109

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu multicentrická studie, časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc24007619

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.

Citace poskytuje Crossref.org

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$a BACKGROUND: We previously reported that the "Endothelial Activation and Stress Index" (EASIX; ((creatinine×lactate dehydrogenase)÷thrombocytes)) measured before start of conditioning predicts mortality after allogeneic hematopoietic stem cell transplantation (alloSCT) when used as continuous score. For broad clinical implementation, a prospectively validated EASIX-pre cut-off is needed that defines a high-risk cohort and is easy to use. METHOD: In the current study, we first performed a retrospective cohort analysis in n=2022 alloSCT recipients and identified an optimal cut-off for predicting non-relapse mortality (NRM) as EASIX-pre=3. For cut-off validation, we conducted a multicenter prospective study with inclusion of n=317 first alloSCTs from peripheral blood stem cell in adult patients with acute leukemia, lymphoma or myelodysplastic syndrome/myeloproliferative neoplasms in the European Society for Blood and Marrow Transplantation network. RESULTS: Twenty-three % (n=74) of alloSCT recipients had EASIX-pre ≥3 taken before conditioning. NRM at 2 years was 31.1% in the high EASIX group versus 11.5% in the low EASIX group (p<0.001). Patients with high EASIX-pre also had worse 2 years overall survival (51.6% vs 70.9%; p=0.002). We were able to validate the cut-off and found that EASIX ≥3 was associated with more than twofold increased risk for NRM in multivariate analysis (HR=2.18, 95% CI 1.2 to 3.94; p=0.01). No statistically significant difference could be observed for the incidence of relapse. CONCLUSIONS: The results of this study provide a prospectively validated standard laboratory biomarker index to estimate the transplant-related mortality risk after alloSCT. EASIX ≥3 taken before conditioning identifies a population of alloSCT recipients who have a more than twofold increased risk of treatment-related mortality.
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$a Benner, Axel $u German Cancer Research Centre, Heidelberg, Germany
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$a Sica, Simona $u Istituto di Ematologia, Universita Cattolica S. Cuore, Rome, Italy
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$a Arat, Mutlu $u Florence Nightingale Hospital, Hematopoietic SCT Unit, Demiroglu Bilim University Istanbul, Istanbul, Turkey
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$a Itäla-Remes, Maija $u Turku University Hospital FI, Turku, Finland
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$a Corral, Lucia López $u Department for Haematology, Hospital Clinico San Carlos, Salamanca, Spain
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$a Schaap, Nicolaas P M $u Department of Hematology, Radboudumc, Nijmegen, The Netherlands
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$a Raida, Ludek $u Olomouc University Social Health Institute, Olomouc, Czech Republic
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$a Schroeder, Thomas $u Dept. of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
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$a Dreger, Peter $u Medicine V, University Hospital Heidelberg, Heidelberg, Germany
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$a Metafuni, Elisabetta $u Istituto di Ematologia, Universita Cattolica S. Cuore, Rome, Italy
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$a Ozcelik, Tulay $u Florence Nightingale Hospital, Hematopoietic SCT Unit, Demiroglu Bilim University Istanbul, Istanbul, Turkey
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$a Sandmaier, Brenda M $u University of Washington, Seattle, Washington, USA
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$a Kordelas, Lambros $u Dept. of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
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$a Moiseev, Ivan $u EBMT Transplant Complications Working Party, Paris, France $u First Pavlov State Medical University of St Petersburg, St Petersburg, Russian Federation
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$a Schoemans, Hélène $u EBMT Transplant Complications Working Party, Paris, France $u Department of Hematology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
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$a Koenecke, Christian $u Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
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$a Basak, Grzegorz W $u EBMT Transplant Complications Working Party, Paris, France $u Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Warsaw, Poland
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