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| Home > Publications database > EASIX in patients with acute graft-versus-host disease: a retrospective cohort analysis. > print |
| 001 | 128092 | ||
| 005 | 20240228145533.0 | ||
| 024 | 7 | _ | |a 10.1016/S2352-3026(17)30108-4 |2 doi |
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| 100 | 1 | _ | |a Luft, Thomas |b 0 |
| 245 | _ | _ | |a EASIX in patients with acute graft-versus-host disease: a retrospective cohort analysis. |
| 260 | _ | _ | |a London [u.a.] |c 2017 |b Elsevier |
| 336 | 7 | _ | |a article |2 DRIVER |
| 336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
| 336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1510750528_10556 |2 PUB:(DE-HGF) |
| 336 | 7 | _ | |a ARTICLE |2 BibTeX |
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| 336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
| 520 | _ | _ | |a Endothelial dysfunction links thrombotic microangiopathy to steroid-refractory graft-versus-host disease (GVHD) after allogeneic stem-cell transplantation. We aimed to assess if the simple formula-lactate dehydrogenase (U/L) × creatinine (mg/dL)/thrombocytes (10(9) cells per L)-termed the Endothelial Activation and Stress Index (EASIX), might be valuable for the prediction of death in patients with acute GVHD after allogeneic stem-cell transplantation.For this retrospective analysis, we analysed a training cohort (in Germany) and three validation cohorts (in Germany and the USA) of patients with acute GVHD who had received consecutive allogeneic stem-cell transplantation. The primary endpoint was prediction of overall survival when measured at acute GVHD onset (EASIX-GVHD). We validated the prognostic strength of EASIX-GVHD for overall survival and non-relapse mortality in the three independent cohorts by calculating the prediction error (integrated Brier score), and concordance index.In the total cohort of patients with acute GVHD (n=311), EASIX-GVHD predicted overall survival in univariable and multivariable models (univariate analysis, hazard ratio [HR] for a one-fold increase 1·16, 95% CI 1·12-1·20, p=0·0004). However, in the subpopulation of patients with myeloablative conditioning (n=72), EASIX-GVHD did not predict overall survival, which is probably attributable to thrombocytopenia at GVHD onset (73 × 10(9) cells per L [IQR 29·75-180·00] for myeloablative conditioning vs 160 × 10(9) cells per L [90·0-250·5] for reduced-intensity conditioning; p<0·0001). In patients who received reduced-intensity conditioning (n=239), EASIX-GVHD was a strong predictor of overall survival (HR for a two-fold change of 1·23, 95% CI 1·13-1·34; p<0·0001) and non-relapse mortality (cause-specific HR for a two-fold change of 1·24, 1·12-1·38; p<0·0001). Model validation for prediction of overall survival and non-relapse mortality by EASIX-GVHD was successful in two independent cohorts of adult patients with reduced-intensity conditioning (n=141, n=173) and in a cohort with mainly paediatric patients (n=89).In patients with reduced-intensity conditioning, EASIX-GVHD is a powerful predictor of survival after GVHD. EASIX-GVHD could be the future basis for development of risk-adapted GVHD treatment strategies.There was no external funding source for this study. |
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| 700 | 1 | _ | |a Jodele, Sonata |b 2 |
| 700 | 1 | _ | |a Dandoy, Christopher E |b 3 |
| 700 | 1 | _ | |a Storb, Rainer |b 4 |
| 700 | 1 | _ | |a Gooley, Ted |b 5 |
| 700 | 1 | _ | |a Sandmaier, Brenda M |b 6 |
| 700 | 1 | _ | |a Becker, Natalia |0 P:(DE-He78)ecb33fb615e08035fdcefcaebfdff8f0 |b 7 |u dkfz |
| 700 | 1 | _ | |a Radujkovic, Aleksandar |b 8 |
| 700 | 1 | _ | |a Dreger, Peter |b 9 |
| 700 | 1 | _ | |a Penack, Olaf |b 10 |
| 773 | _ | _ | |a 10.1016/S2352-3026(17)30108-4 |g Vol. 4, no. 9, p. e414 - e423 |0 PERI:(DE-600)2802056-X |n 9 |p e414 - e423 |t The @lancet |v 4 |y 2017 |x 2352-3026 |
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