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@ARTICLE{Penack:286992,
author = {O. Penack and T. Luft and C. Peczynski and A. Benner$^*$
and S. Sica and M. Arat and M. Itäla-Remes and L. L. Corral
and N. P. M. Schaap and M. Karas and L. Raida and T.
Schroeder and P. Dreger and E. Metafuni and T. Ozcelik and
B. M. Sandmaier and L. Kordelas and I. Moiseev and H.
Schoemans and C. Koenecke and G. W. Basak and Z. Peric},
title = {{E}ndothelial {A}ctivation and {S}tress {I}ndex ({EASIX})
to predict mortality after allogeneic stem cell
transplantation: a prospective study.},
journal = {Journal for ImmunoTherapy of Cancer},
volume = {12},
number = {1},
issn = {2051-1426},
address = {London},
publisher = {BioMed Central},
reportid = {DKFZ-2024-00109},
pages = {e007635},
year = {2024},
abstract = {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.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.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.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.},
keywords = {Hematologic Neoplasms (Other) / Immunotherapy (Other) /
Inflammation (Other)},
cin = {C060},
ddc = {610},
cid = {I:(DE-He78)C060-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38199608},
doi = {10.1136/jitc-2023-007635},
url = {https://inrepo02.dkfz.de/record/286992},
}