Muratore Edoardo, Gambuti Giacomo, Leardini Davide, Baccelli Francesco, Venturelli Francesco, Larcinese Leyna, Gottardi Francesca, Di Battista Antonia, Belotti Tamara, Prete Arcangelo, Masetti Riccardo
Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Bone Marrow Transplant. 2025 Mar;60(3):346-352. doi: 10.1038/s41409-024-02489-8. Epub 2024 Dec 10.
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.
内皮激活与应激指数（EASIX）评分的计算方法为[乳酸脱氢酶（LDH；单位：U/L）×血清肌酐（单位：mg/dL）]/血小板计数（单位：10⁹/L），已被证明可预测接受异基因干细胞移植（allo-HSCT）的成人的非复发死亡率（NRM）和内皮并发症；然而，儿童患者缺乏确切结果。我们回顾性评估了连续的儿科allo-HSCT受者，并从入院至+35天每天计算log₂EASIX评分。在167例allo-HSCT受者中，EASIX评分从预处理前的-0.79增加至+20天的最高评分2.23。多因素分析显示，+7天时的EASIX评分是窦性阻塞综合征/静脉闭塞性疾病（SOS/VOD）（比值比[OR] 1.52；95%置信区间[CI]，1.08 - 2.13；p = 0.017）和NRM（OR 1.68；95% CI 1.16 - 2.42；p = 0.006）的独立预测因素。在+0天至+14天的多个时间点，EASIX评分与NRM独立相关，在+12天时观察到最强的预测能力（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，但即使在多因素模型中加入年龄，评分预测仍得到证实，这表明年龄不是观察到的关联中的混杂因素。移植后不久确定的EASIX评分可进一步作为儿科allo-HSCT受者SOS/VOD和NRM的预测指标进行探索。
