The EASIX score as a predictor of sinusoidal obstruction syndrome and nonrelapse mortality in paediatric patients receiving allogeneic haematopoietic stem cell transplantation.

IF 4.5 2区 医学 Q1 HEMATOLOGY Bone Marrow Transplantation Pub Date : 2024-12-10 DOI:10.1038/s41409-024-02489-8
Edoardo Muratore, Giacomo Gambuti, Davide Leardini, Francesco Baccelli, Francesco Venturelli, Leyna Larcinese, Francesca Gottardi, Antonia Di Battista, Tamara Belotti, Arcangelo Prete, Riccardo Masetti
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Abstract

The endothelial activation and stress index (EASIX) score, calculated as [lactate dehydrogenase (LDH; U/L) × serum creatinine (mg/dL)]/platelets (10e9/L)], has been shown to be predictive of nonrelapse mortality (NRM) and endothelial complications in adults receiving allogeneic stem cell transplantation (allo-HSCT); however, definitive results are lacking for children. We retrospectively evaluated consecutive paediatric allo-HSCT recipients and calculated the log2 EASIX score every day from admission to day +35. In 167 allo-HSCT recipients, the EASIX score increased from before conditioning (-0.79) to a maximum score on day +20 (2.23). In multivariate analysis, the EASIX score at day +7 was an independent predictor of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) (OR 1.52; 95% CI, 1.08-2.13; p = 0.017) and NRM (OR 1.68; 95% CI 1.16-2.42; p = 0.006). At several time points between day +0 and day +14, the EASIX score was independently associated with NRM, with the strongest predictive power being observed on day +12 (OR 3.05; 95% CI, 1.53-6.10; p = 0.002). Age correlated linearly with the EASIX score at all analysed time points, but score prediction was confirmed even when age was added to the multivariate model, indicating that age was not a confounding factor in the observed associations. The EASIX score determined shortly after transplantation can be further explored as a predictor of SOS/VOD and NRM in paediatric allo-HSCT recipients.

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EASIX评分作为接受同种异体造血干细胞移植的儿科患者鼻窦阻塞综合征和非复发死亡率的预测因子。
内皮活化和应激指数(EASIX)评分,计算方法为[乳酸脱氢酶(LDH);U/L) ×血清肌酐(mg/dL)]/血小板(10e9/L)],已被证明可预测接受同种异体干细胞移植(alloo - hsct)的成人非复发死亡率(NRM)和内皮并发症;然而,对于儿童,尚无明确的结果。我们回顾性评估了连续的儿科同种异体造血干细胞移植接受者,并计算了从入院到第35天每天的log2 EASIX评分。在167例同种异体造血干细胞移植受者中,EASIX评分从条件反射前(-0.79)增加到+20天的最高分(2.23)。在多变量分析中,第7天的EASIX评分是窦状静脉阻塞综合征/静脉闭塞性疾病(SOS/VOD)的独立预测因子(OR 1.52;95% ci, 1.08-2.13;p = 0.017)和NRM (OR 1.68;95% ci 1.16-2.42;p = 0.006)。在第0天至第14天之间的几个时间点,EASIX评分与NRM独立相关,其中第12天的预测能力最强(OR 3.05;95% ci, 1.53-6.10;p = 0.002)。在所有分析的时间点,年龄与EASIX评分呈线性相关,但即使在多变量模型中加入年龄,得分预测也得到证实,这表明年龄不是观察到的关联的混杂因素。移植后不久确定的EASIX评分可以进一步作为儿科同种异体造血干细胞移植受者SOS/VOD和NRM的预测因子。
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来源期刊
Bone Marrow Transplantation
Bone Marrow Transplantation 医学-免疫学
CiteScore
8.40
自引率
8.30%
发文量
337
审稿时长
6 months
期刊介绍: Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.
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