LAUSR

Background Allogeneic hematopoietic stem cell transplant (HCT) is a potentially curative treatment modality for patients with AML. However, the success of transplant is limited by transplant-related mortality. Post-transplant complications have been linked to endothelial damage through derangements in vascular and blood cell homeostasis. The EASIX (Endothelial Activation and Stress Index) score has been studied as a marker for endothelial dysfunction in the setting of allo-HCT using routine laboratory tests (LDH) x serum creatinine (mg/dL)/ Platelets (109 cells/L). The aim of this study is to investigate the prognostic value of a post-transplant day-100 EASIX score in patients with AML. Methods In this single-center retrospective study, 237 patients with AML who underwent a first allo-HCT between 2013-2018 were included. Those alive at 100 days post-transplant were stratified by scores of less than 1, 1-1.99, 2-2.99, and 3 and above. Kaplan Meier survival analysis and hazard ratios using cox regression models were employed to assess overall survival. Results There were no significant baseline differences between groups except for recipient sex [p=0.02]. Survival analysis demonstrated a decreased overall survival with incremental increases in 100-day EASIX scores (p=0.001) with a 2-year overall survival of 67.3% ( Conclusion Endothelial dysfunction contributes significantly to the pathophysiology of complications after transplant. Our data suggests that in patients with AML undergoing HCT, a 100-day EASIX score can be used as a predictor to identify those who are at increased risk of poor outcomes after transplant. This is especially important in settings where patients are discharged from the transplant program after 100 day work-up.