The Pretherapy Endothelial Activation and Stress Index (EASIX) in Patients with Newly Diagnosed Acute Myeloid Leukemia: A Pilot Study.
5 affiliations
- 1Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway.
- 2Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
- 3K.G. Jebsen Center for Myeloid Blood Cancer, Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5021 Bergen, Norway.
- 4Department of Medicine, Haraldsplass Deaconess Hospital, P.O. Box 6165, N-5892 Bergen, Norway.
- 5Department of Nursing, VID Specialized University, Bergen Campus, Ulriksdal 10, N-5009 Bergen, Norway.
Abstract
Background/Objectives: The endothelial activation and stress index (EASIX; serum creatinine times lactate dehydrogenase/peripheral blood platelet count) seems to reflect endothelial cell activation/dysfunction. Furthermore, endothelial cells support acute myeloid leukemia (AML) cell proliferation and survival, and high bone marrow microvascular density is associated with adverse prognosis in human AML. Methods: We investigated the pretreatment EASIX score in 160 AML patients (promyelocytic variants excluded) at the time of diagnosis before initiation of intensive cytarabine-based anti-AML therapy. Results: We detected a significant association between the pretreatment EASIX score and the monocytic AML cell phenotype (Fisher's test, p = 0.0007). A weaker association was observed between a high pretreatment EASIX score and C-reactive protein levels (Spearman's test, p = 0.017). We could not detect any significant difference in 5-year overall survival when comparing patient subsets with a pretreatment EASIX score below versus above the median cohort level (Kaplan-Meier's test, p = 0.84), and the overall survival did not differ when comparing overall survival for the two contrasting upper and lower quartiles either (p = 0.88). Furthermore, the 5-year posttransplant survival did not differ between allotransplant recipients (n = 58) with a pretreatment (i.e., at the time of first diagnosis) EASIX score below versus above the cohort median level (p = 0.55). Finally, the 5-year overall survival did not differ when comparing patients with low versus high modified EASIX scores either (p = 0.46). Conclusions: Our study suggests that the pretherapy EASIX score does not have any prognostic impact in non-promyelocytic AML patients receiving conventional intensive AML therapy. This is different from patients with promyelocytic AML variants, in whom a high EASIX score is associated with increased mortality. However, EASIX scoring should be further investigated in AML patients who receive new targeted therapies, including BCL2-inhibition, which is less effective in monocytic AML variants.
Related
- Eltrombopag during induction chemotherapy in older patients with newly diagnosed acute myeloid leukemia is safe and reduces platelet transfusion requirements: The EPAG-2015 French Innovative Leukemia Organization phase 2 randomized trial.
- Effects of azacitidine combined with venetoclax on inflammatory markers and overall response rate in elderly patients with newly diagnosed acute myeloid leukemia
- Multimodal Artificial Intelligence Fusion Models to Predict Response to Venetoclax and Azacitidine in Patients with Newly Diagnosed Acute Myeloid Leukemia
- Prognostic Value of the Modified Endothelial Activation and Stress Index (m-EASIX) for 90-Day Mortality in Patients with Moderate-to-Severe Hypercalcemia of Malignancy
- The relationship between endothelial activation and stress index (EASIX) and the incidence of major adverse cardiovascular events in acute myocardial infarction patients admitted in emergency department.
BibTeX
@article{bruserud2026pretherapy,
title = {{The Pretherapy Endothelial Activation and Stress Index (EASIX) in Patients with Newly Diagnosed Acute Myeloid Leukemia: A Pilot Study.}},
author = {Øystein Bruserud and Guido Smits and Silje Johansen and Espen Talseth Skar and Øystein Wendelbo and Håkon Reikvam},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193117},
url = {https://europepmc.org/article/MED/42882271},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Pretherapy Endothelial Activation and Stress Index (EASIX) in Patients with Newly Diagnosed Acute Myeloid Leukemia: A Pilot Study.
AU - Øystein Bruserud
AU - Guido Smits
AU - Silje Johansen
AU - Espen Talseth Skar
AU - Øystein Wendelbo
AU - Håkon Reikvam
PY - 2026
DA - 2026/09/25
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193117
UR - https://europepmc.org/article/MED/42882271
AB - Background/Objectives: The endothelial activation and stress index (EASIX; serum creatinine times lactate dehydrogenase/peripheral blood platelet count) seems to reflect endothelial cell activation/dysfunction. Furthermore, endothelial cells support acute myeloid leukemia (AML) cell proliferation and survival, and high bone marrow microvascular density is associated with adverse prognosis in human AML. Methods: We investigated the pretreatment EASIX score in 160 AML patients (promyelocytic variants excluded) at the time of diagnosis before initiation of intensive cytarabine-based anti-AML therapy. Results: We detected a significant association between the pretreatment EASIX score and the monocytic AML cell phenotype (Fisher's test, p = 0.0007). A weaker association was observed between a high pretreatment EASIX score and C-reactive protein levels (Spearman's test, p = 0.017). We could not detect any significant difference in 5-year overall survival when comparing patient subsets with a pretreatment EASIX score below versus above the median cohort level (Kaplan-Meier's test, p = 0.84), and the overall survival did not differ when comparing overall survival for the two contrasting upper and lower quartiles either (p = 0.88). Furthermore, the 5-year posttransplant survival did not differ between allotransplant recipients (n = 58) with a pretreatment (i.e., at the time of first diagnosis) EASIX score below versus above the cohort median level (p = 0.55). Finally, the 5-year overall survival did not differ when comparing patients with low versus high modified EASIX scores either (p = 0.46). Conclusions: Our study suggests that the pretherapy EASIX score does not have any prognostic impact in non-promyelocytic AML patients receiving conventional intensive AML therapy. This is different from patients with promyelocytic AML variants, in whom a high EASIX score is associated with increased mortality. However, EASIX scoring should be further investigated in AML patients who receive new targeted therapies, including BCL2-inhibition, which is less effective in monocytic AML variants.
SN - 2075-4418
ER -