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EASIX and mortality after allogeneic stem cell transplantation

by Sandmaier, Brenda M , Beelen Dietrich , Dreger, Peter , Penack Olaf , Sorror Mohamed , Luft, Thomas , Zeisbrich Markus , Benner, Axel , Kordelas Lambros , Terzer Tobias , Dandoy, Christopher E , Storb Rainer , Jodele Sonata , Gooley, Ted , Radujkovic Aleksandar

in Biomarkers / Complications / Creatinine / Hematology / Homeostasis / Immunotherapy / Insulin / Interleukin 18 / Interleukins / Mortality / Platelets / Prediction models / Serum levels / Stem cell transplantation / Stem cells / Thrombocytes / Training / Transplantation / Transplants & implants

2020

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2020

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2020

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Journal Article

EASIX and mortality after allogeneic stem cell transplantation

Sandmaier, Brenda M,

Beelen Dietrich,

Dreger, Peter,

Penack Olaf,

Sorror Mohamed,

Luft, Thomas,

Zeisbrich Markus,

Benner, Axel,

Kordelas Lambros,

Terzer Tobias,

Dandoy, Christopher E,

Storb Rainer,

Jodele Sonata,

Gooley, Ted,

Radujkovic Aleksandar

2020

Overview

Allogeneic stem cell transplantation (alloSCT) is an effective immunotherapy in patients with hematological malignancies. Endothelial dysfunction was linked to major complications after alloSCT. We asked the question if the “Endothelial Activation and Stress Index” (EASIX; [(creatinine × LDH) ÷ thrombocytes]) can predict mortality after alloSCT. We performed a retrospective cohort analysis in five alloSCT centers in the USA and Germany. EASIX was assessed prior to conditioning (EASIX-pre) and correlated with mortality in 755 patients of a training cohort in multivariable models. The predictive model established in the training cohort was validated in 1267 adult allo-recipients. Increasing EASIX-pre predicted lower overall survival (OS) after alloSCT, and successful model validation was achieved for the validation cohort. We found that EASIX-pre predicts OS irrespective of established scores. Moreover, EASIX-pre was also a significant prognostic factor for transplant-associated microangiopathy. Finally, EASIX-pre correlated with biomarkers of endothelial homeostasis such as CXCL8, interleukin-18, and insulin-like-growth-factor-1 serum levels. This study establishes EASIX-pre based on a standard laboratory biomarker panel as a predictor of individual risk of mortality after alloSCT independently from established clinical criteria.

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Publisher

Nature Publishing Group

Subject

/ Insulin