The Pretransplant EASIX Score Predicts Transplant-Related Mortality in Children Undergoing Hematopoietic Stem Cell...

Area of Science:

• Pediatric Hematology
• Transplantation Immunology
• Biomarker Discovery

Background:

• Hematopoietic stem cell transplantation (HSCT) carries significant risks for pediatric patients.
• The Endothelial Activation and Stress Index (EASIX) is a validated adult risk assessment tool.
• Limited data exists on EASIX utility in pediatric HSCT for non-malignant diseases.

Purpose of the Study:

• To evaluate the pretransplant EASIX score (EASIXpre) as a predictor of transplant-related mortality (TRM) in pediatric patients.
• To determine an optimal EASIXpre cut-off for risk stratification in this population.
• To assess the association between EASIXpre and overall survival post-HSCT.

Main Methods:

• Retrospective analysis of 475 pediatric patients with non-malignant diseases undergoing allogeneic HSCT.
• Receiver Operating Characteristic (ROC) curve analysis to identify the optimal EASIXpre cut-off value.
• Kaplan-Meier survival analysis and multivariate Cox regression to assess TRM and overall survival.

Main Results:

• An EASIXpre cut-off of 2 was identified as optimal via ROC analysis.
• Patients with high EASIXpre scores (≥2) had significantly higher TRM (24.6%) compared to low scores (<2) (7.9%) within two years (p < 0.001).
• Two-year overall survival was significantly lower in the high EASIXpre group (73.6%) versus the low EASIXpre group (92.3%) (p < 0.001).

Conclusions:

• The pretransplant EASIX score is a valuable, cost-effective biomarker for predicting transplant outcomes in pediatric HSCT for non-malignant conditions.
• The identified EASIXpre cut-off of 2 demonstrates internal consistency for TRM prediction in this cohort.
• Further external validation in independent pediatric cohorts is required to confirm these findings.