The EAS(E)IX of predicting sepsis after allogeneic hematopoietic cell transplantation

Excerpt

Various scoring systems have been developed and validated to predict overall outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) by considering a patient’s comorbidities, disease-specific characteristics, and donor-specific elements [1, 2]. The Endothelial Activation Stress Index (EASIX) is an easy scoring system first described in 2017 aimed at predicting overall mortality and mortality after the development of acute graft-versus-host disease (GVHD) in patients post-allo-HCT [3]. The score is derived from three common laboratory parameters that are associated with endothelial dysfunction from the diagnostic criteria of transplantation-associated thrombotic microangiopathy (TA-TMA), that is lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10⁹/L), and can be collected at various time points of an allo-HCT patient’s clinical course. Endothelial dysfunction is a key feature of other important complications of allo-HCT that may require admission to the intensive care unit (ICU) including GVHD, sinusoidal obstruction syndrome (SOS/VOD),® idiopathic pneumonia syndrome, and sepsis [4]. Therefore, EASIX may help clinicians to longitudinally assess the potential risks of complications during the post-allo-HCT course [5]. …