Prognostic impact of P-m-EASIX at neutrophil engraftment after allogeneic hematopoietic stem cell transplantation

Although the Endothelial Activation and Stress Index (EASIX) correlates with patient outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT), its prognostic value at neutrophil engraftment remains unclear. Elevated C-reactive protein (CRP) levels and hypophosphatemia at neutrophil engraftment correlate with worse outcomes after allo-HSCT. P-m-EASIX, which incorporates CRP, phosphorus, lactate dehydrogenase, and platelet count, may therefore correlate with outcomes after allo-HSCT. We retrospectively investigated the association between P-m-EASIX at neutrophil engraftment and outcomes in 114 patients who underwent their first allo-HSCT at our institution. P-m-EASIX at neutrophil engraftment was significantly higher in non-survivors than in survivors after allo-HSCT. In multivariate analyses, a P-m-EASIX ≥ 0.24 at neutrophil engraftment was an independent predictor of poor overall survival (hazard ratio [HR], 2.79; 95% confidence interval [CI], 1.56-4.99; P < 0.01) and an independent risk factor for non-relapse mortality (HR, 3.66; 95% CI, 1.33-10.06; P = 0.01). This study shows that the P-m-EASIX at neutrophil engraftment correlates with outcomes after allo-HSCT.