EASIX-1year and late mortality after allogeneic stem cell transplantation

• Verfasst von: Kordelas, Lambros [VerfasserIn]
• Verfasst von: Terzer, Tobias [VerfasserIn]
• Verfasst von: Gooley, Ted [VerfasserIn]
• Verfasst von: Davis, Chris [VerfasserIn]
• Verfasst von: Sandmaier, Brenda M. [VerfasserIn]
• Verfasst von: Sorror, Mohamed [VerfasserIn]
• Verfasst von: Penack, Olaf [VerfasserIn]
• Verfasst von: Schaeper, Nigel D. E. [VerfasserIn]
• Verfasst von: Blau, Igor-Wolfgang [VerfasserIn]
• Verfasst von: Beelen, Dietrich W. [VerfasserIn]
• Verfasst von: Radujković, Aleksandar [VerfasserIn]
• Verfasst von: Dreger, Peter [VerfasserIn]
• Verfasst von: Luft, Thomas [VerfasserIn]
• Titel: EASIX-1year and late mortality after allogeneic stem cell transplantation
• Verf.angabe: Lambros Kordelas, Tobias Terzer, Ted Gooley, Chris Davis, Brenda M. Sandmaier, Mohamed Sorror, Olaf Penack, Nigel D.E. Schaeper, Igor W. Blau, Dietrich Beelen, Aleksandar Radujkovic, Peter Dreger, and Thomas Luft
• E-Jahr: 2023
• Jahr: September 15, 2023
• Umfang: 8 S.
• Fussnoten: Gesehen am 08.01.2024
• Titel Quelle: Enthalten in: Blood advances
• Ort Quelle: Washington, DC : American Society of Hematology, 2016
• Jahr Quelle: 2023
• Band/Heft Quelle: 7(2023), 18 vom: Sept., Seite 5374-5381
• ISSN Quelle: 2473-9537
• DOI: doi:10.1182/bloodadvances.2022008617
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1877420182

Abstract

Abstract - Patients with hematological malignancies who survive the first year after allogeneic stem cell transplantation (allo-SCT) without relapse have a substantial risk of nonrelapse mortality (NRM) and missing predictive markers. The Endothelial Activation and Stress Index (EASIX) predicts endothelial complications and NRM early after allo-SCT. We hypothesized that EASIX assessed 1 year after allo-SCT in survivors who were disease free may predict late NRM. Survivors who were relapse-free at 1 year after allo-SCT were retrospectively studied in 2 independent cohorts (training cohort, n = 610; merged validation cohort, n = 852). EASIX determined 1 year after allo-SCT correlated with the overall survival (OS), NRM, and relapse. Serum endothelial and inflammatory markers were measured in the training cohort and correlated with EASIX-1year, which predicted OS and NRM but not relapse risk in both the training and validation cohorts in univariable and multivariable Cox regression analyses. Brier score and c-index analyses validated the univariable EASIX effects. There was no significant interaction between EASIX-1year and incidence of chronic graft-versus-host disease (GVHD) on OS. EASIX-1year predicted the outcome irrespective of preexisting comorbidities. Principal causes of NRM in both training and validation cohorts were infections with and without GVHD as well as cardiovascular complications. EASIX-1year correlated with sCD141 and interleukin-18 but not with C-reactive protein, suppressor of tumorigenicity-2, angiopoietin-2, CXCL9, or CXCL8. To our knowledge, EASIX-1year is the first validated predictor of late overall and NRM. Patients who are high risk as defined by EASIX-1year might be considered for intensified surveillance and prophylactic measures.