文章：

EASIX预测低危骨髓增生异常综合征的生存期

EASIX for prediction of survival in lower-risk myelodysplastic syndromes

原文发布日期：2019-11-11

DOI: 10.1038/s41408-019-0247-z

类型: Article

开放获取: 是

英文摘要：

Patients with myelodysplastic syndromes (MDS) are at risk of early death from cardiovascular complications due to the link between clonal hematopoiesis and endothelial dysfunction. EASIX (Endothelial Activation and Stress Index) has been established to predict endothelial complications after allogeneic transplantation. We investigated the impact of EASIX measured at first diagnosis on survival of patients with lower- and higher-risk MDS (no allogeneic transplantation) in two independent institutions: n = 192 (training cohort) and n = 333 (validation cohort). Serum markers of endothelial cell distress were measured and correlated to EASIX. While no effects of EASIX on survival were observed in higher-risk patients, EASIX was associated with shorter survival in patients with lower-risk MDS in both cohorts (univariate: Cohort I: hazard ratio (HR): 1.46; 95% confidence interval (CI) 1.24–1.71; p-value < 0.001/Cohort II: HR 1.31 [1.17–1.48]; p-value < 0.001). Multivariate Cox regression analysis and prediction error analyses confirmed that EASIX remained a significant predictor of survival after adjustment for age, sex, cytogenetic abnormalities and bone marrow blasts in lower-risk patients. The model of the training cohort could be validated. Serum levels of Angiopioetin-2 correlated significantly with EASIX. We introduce EASIX as an easily accessible and independent predictor for survival in patients with lower-risk MDS.
 

摘要翻译： 

骨髓增生异常综合征（MDS）患者因克隆性造血与内皮功能障碍之间的关联，面临心血管并发症导致早期死亡的风险。EASIX（内皮细胞活化与应激指数）已被确立用于预测异基因移植后的内皮并发症。我们在两个独立机构中调查了首次诊断时测量的EASIX对未接受异基因移植的低危和高危MDS患者生存的影响：n=192（训练队列）和n=333（验证队列）。测量了内皮细胞应激的血清标志物并与EASIX进行相关性分析。在高危患者中未观察到EASIX对生存的影响，而在两个队列中，EASIX与低危MDS患者的较短生存期相关（单变量分析：队列I：风险比（HR）：1.46；95%置信区间（CI）1.24–1.71；p值<0.001/队列II：HR 1.31 [1.17–1.48]；p值<0.001）。多变量Cox回归分析和预测误差分析证实，在调整年龄、性别、细胞遗传学异常和骨髓原始细胞后，EASIX在低危患者中仍是生存的显著预测因子。训练队列的模型得到验证。血管生成素-2的血清水平与EASIX显著相关。我们引入EASIX作为低危MDS患者生存的一个易获取且独立的预测因子。

原文链接：

EASIX for prediction of survival in lower-risk myelodysplastic syndromes