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EASIX predicts SOS/VOD after alloSCT
(OR per log2 increase 1.31, 95%CI:1.08-1.59, P=0.0067) (Figure 2A). Similarly, EASIX-d0 was strongly associated with the incidence of SOS/VOD in the validation cohort (univariable analysis: OR per log2 increase 1.50, 95%CI: 1.22-1.88, P=0.0002; multivariable analysis: OR per log2 increase 1.57, 95%CI: 1.26-2.01, P=0.0001) (Figure 2B).
Based on these data, we have created the EASIX-d0 SOS/VOD calculator for free public use (http://biostatis- tics.dkfz.de/EASIX/).
Association of EASIX-d0 with overall survival and non-relapse mortality
In the training cohort, EASIX-d0 was significantly asso- ciated with OS and NRM in univariable analysis (OS: HR per log2 increase 1.20, 95%CI: 1.12-1.29, P<0.0001; NRM: cause-specific hazard ratio [CSHR] per log2 increase 1.25, 95%CI: 1.14-1.38, P<0.0001) (Figure 3A and C). Likewise, EASIX-d0 was significantly associated with OS and NRM in the validation cohort in univariable analysis (OS: HR
per log2 increase 1.10, 95%CI: 1.02-1.18, P=0.0124; NRM: CSHR per log2 increase 1.18, 95%CI: 1.06-1.32, P=0.0024) (Figure 3B and D).
Association of the CIBMTR clinical risk score with sinusoidal obstruction syndrome/veno-occlusive disease incidence, overall survival and non-relapse mortality
In the training cohort, a non-significant trend towards a higher median CIBMTR score was observed in patients who subsequently developed SOS/VOD as compared to patients who did not develop SOS/VOD (1.51; IQR 0.82- 2.37 vs. 1.01; IQR 0.76-1.80, P=0.069). In the validation cohort, the median CIBMTR score in patients with SOS/VOD was significantly higher than that in patients without SOS/VOD (1.92; IQR 1.44-3.09 vs. 1.20; IQR 0.89-2.15, P=0.00053). On time-to-event analysis, howev- er, the association of the CIBMTR score with SOS/VOD incidence was not statistically significant in the training
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Figure 1. Endothelial Activation and Stress Index (EASIX) assessed at the day of alloSCT (EASIX-d0) in patients without sinusoidal obstruction syndrome/veno-occlu- sive disease (SOS/VOD) versus EASIX-d0 in patients with SOS/VOD. Box plot of EASIX-d0 in patients without SOS/VOD (No VOD) versus EASIX-d0 in patients with SOS/VOD (VOD)) in (A) the training and (B) the validation cohort.
Figure 2. Time to sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) depending on Endothelial Activation and Stress Index (EASIX) assessed at the day of alloSCT (EASIX-d0) quartiles. (A) Training and (B) validation cohort. SCT: stem cell transplantation.
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