Tolosa-Ridao Carles, Cascos Enric, Rodríguez-Lobato Luis Gerardo, Pedraza Alexandra, Suárez-Lledó María, Charry Paola, Solano María Teresa, Martinez-Sanchez Julia, Cid Joan, Lozano Miquel, Rosiñol Laura, Esteve Jordi, Urbano-Ispizua Álvaro, Fernández-Avilés Francesc, Martínez Carmen, Carreras Enric, Díaz-Ricart Maribel, Rovira Montserrat, Salas María Queralt
Hematology Department, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Hematopoietic Transplantation Unit, Hematology Department, Clinical Institute of Hematology and Oncology (ICMHO), Hospital Clínic de Barcelona, Barcelona, Spain.
Bone Marrow Transplant. 2024 Jul;59(7):974-982. doi: 10.1038/s41409-024-02270-x. Epub 2024 Mar 23.
This study investigates the interaction between endothelial activation, indirectly measured using EASIX, and the probability of presenting cardiac adverse events (CAE) during the first year after allo-HCT. The 437 consecutive adults undergoing PB allo-HCT from 2012 and 2021 were included. EASIX was retrospectively calculated before and during the first 6 months after allo-HCT and transformed to log2-base to conduct the statistical analysis. The median age was 53, 46 (10.5%) patients had previous history of cardiac disease, MAC allo-HCTs were performed in 186 (42.6%) patients, and PTCY was administered in 242 (55.5%). The 1-year incidence of CAE was 12.6% (n = 55). The most prevalent cardiac events were heart failure and arrhythmias, 32.7% and 23.6% respectively, and the day +100 mortality rate of these patients was 40.5%. During the first 6 months after allo-HCT, EASIX trends were significantly higher in patients who developed CAE. Regression analyses confirmed that higher log2-EASIX values were predictors for higher risk for CAE during the first year after allo-HCT. This analysis identifies a significant association between higher endothelial activation, indirectly measured using EASIX, and higher risk for cardiac toxicity diagnosed during the first year after allo-HCT and extends the applicability of EASIX for identifying patients at risk for CAE.
本研究调查了使用EASIX间接测量的内皮细胞激活与异基因造血干细胞移植（allo-HCT）后第一年出现心脏不良事件（CAE）的概率之间的相互作用。纳入了2012年至2021年连续接受外周血allo-HCT的437名成年人。在allo-HCT前及术后前6个月回顾性计算EASIX，并转换为以2为底的对数进行统计分析。中位年龄为53岁，46名（10.5%）患者有心脏病史，186名（42.6%）患者进行了清髓性allo-HCT，242名（55.5%）患者接受了PTCY治疗。CAE的1年发病率为12.6%（n = 55）。最常见的心脏事件是心力衰竭和心律失常，分别为32.7%和23.6%，这些患者在移植后第100天的死亡率为40.5%。在allo-HCT后的前6个月，发生CAE的患者的EASIX趋势显著更高。回归分析证实，较高的log2-EASIX值是allo-HCT后第一年CAE风险较高的预测指标。该分析确定了使用EASIX间接测量的较高内皮细胞激活与allo-HCT后第一年诊断出的较高心脏毒性风险之间存在显著关联，并扩展了EASIX在识别CAE风险患者中的适用性。
