Preconditioning Modified-Easix as a Predictor of Prognosis in Allogeneic Hematopoietic Stem Cell Transplant Recipients.
Zeynep Arzu YeğinEmine Merve SavaşŞeyma YıldızMünevver İrem KökMeltem Büşra ErdemirBaşak Bostankolu DeğirmenciZübeyde Nur ÖzkurtMünci YağcıPublished in: Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion (2023)
Allogeneic hematopoietic stem cell transplantation (alloHCT) is associated with severe complications, most of which share a common physiopathological background characterized by endothelial dysfunction. A novel risk assessment model, endothelial activation and stress index (EASIX), has been introduced as a predictor of endothelial activation. This retrospective study was performed to evaluate the predictive impact of EASIX/modified-EASIX (mEASIX) on transplant outcome. Medical records of 398 alloHCT recipients [median age: 43(17-71) years; M/F: 243/155] were examined. EASIX/mEASIX were calculated at specific time points before and after transplantation. EASIX/mEASIX were significantly associated with transplant complications including engraftment syndrome, sinusoidal obstruction syndrome, febrile neutropenia and transplant associated thrombotic microangiopathy. The probability of overall survival was significantly higher in low-preconditioning mEASIX (day -7) group (37% vs 25.2%; p = 0.008; HR: 2.057; 95% CI: 1.208-3.504). The probabilities of day30 mortality (2.9% vs 19.4%; p = 0.017; HR: 7.028; 95% CI: 1.418-34.836), day100 mortality (9% vs 33%; p = 0.004; HR: 4.469; 95% CI: 1.619-12.336) and non relapse mortality (44.8% vs 61.4%; p = 0.005; HR: 2.551; 95% CI: 1.318-4.941) were lower in low-preconditioning mEASIX (day -7) group. This retrospective cohort analysis demonstrates the significant impact of EASIX/mEASIX on transplant complications and survival. Prospective analyses are mandatory to assess the predictive role of EASIX/mEASIX in clinical practice.
Keyphrases
- hematopoietic stem cell
- risk factors
- allogeneic hematopoietic stem cell transplantation
- risk assessment
- cardiovascular events
- clinical practice
- ischemia reperfusion injury
- endothelial cells
- free survival
- stem cell transplantation
- healthcare
- acute lymphoblastic leukemia
- acute myeloid leukemia
- type diabetes
- bone marrow
- cross sectional
- early onset
- oxidative stress
- heavy metals
- high dose
- cardiovascular disease
- blood brain barrier
- mesenchymal stem cells
- brain injury
- urinary tract infection
- chemotherapy induced
- drug induced
- cord blood