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@ARTICLE{Dai:167287,
      author       = {H. Dai$^*$ and O. Penack and A. Radujkovic and D. Schult
                      and J. Majer-Lauterbach and I. W. Blau and L. Bullinger and
                      S. Jiang and C. Müller-Tidow and P. Dreger and T. Luft},
      title        = {{E}arly bilirubinemia after allogeneic stem cell
                      transplantation-an endothelial complication.},
      journal      = {Bone marrow transplantation},
      volume       = {56},
      number       = {7},
      issn         = {0268-3369},
      address      = {London},
      publisher    = {Nature Publishing Group55086},
      reportid     = {DKFZ-2021-00242},
      pages        = {1573-1583},
      year         = {2021},
      note         = {#EA:C020# / 2021 Jul;56(7):1573-1583},
      abstract     = {Hyperbilirubinemia occurs frequently after allogeneic stem
                      cell transplantation. Causes include primary liver damage
                      and endothelial complications as major contributors. Here,
                      we have investigated the impact of early bilirubinemia (EB)
                      on posttransplant outcomes. Maximum total bilirubin levels
                      (days 0-28) were categorized using maximally selected log
                      rank statistics to identify a cut off for the endpoint
                      non-relapse mortality (NRM) in a training cohort of 873
                      patients. EB above this cut off was correlated with NRM and
                      overall survival (OS) and with pre- and posttransplant
                      Angiopoietin-2, interleukin (IL)18, CXCL8 and suppressor of
                      tumorigenicity-2 (ST2) serum levels, and the endothelial
                      activation and stress index (EASIX). Clinical correlations
                      were validated in a sample of 388 patients transplanted in
                      an independent institution. The EB cut off was determined at
                      3.6 mg/dL (61.6 µM). EB predicted OS (HR 1.60, $95\%$ CI
                      1.21-2.12, p < 0.001), and NRM (CSHR 2.14; 1.28-3.56, p =
                      0.004), also independent of typical endothelial
                      complications such as veno-occlusive disease, refractory
                      acute graft-versus-host disease, or transplant-associated
                      microangiopathy. However, EB correlated with high
                      Angiopoietin-2, EASIX-pre and EASIX-day 0, as well as
                      increased levels of posttransplant CXCL8, IL18, and ST2. In
                      summary, EB indicates a poor prognosis. The association of
                      EB with endothelial biomarkers suggests an endothelial
                      pathomechanism also for this posttransplant complication.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33517355},
      doi          = {10.1038/s41409-020-01186-6},
      url          = {https://inrepo02.dkfz.de/record/167287},
}