Clinical practice of the endothelial activation and stress index and its modified versions in multiple myeloma and the effects on prognosis

Objective: Here, we aimed to evaluate the prognostic values of the endothelial activation and stress index (EASIX) and its derivatives, modified EASIX (mEASIX) and simplified EASIX (sEASIX), in patients with multiple myeloma (MM). Methods: The data of 134 newly diagnosed MM patients between January 2020 and December 2024 were retrospectively analyzed. Patients were divided into groups based on EASIX and its derivatives, and the outcomes of survival rates in groups were compared. Optimal cut-off points were determined using the receiver-operating characteristic analysis, and mortality predictive values of the scores were investigated. The independent prognostic factors were evaluated through univariate and multivariate Cox regression analyses. Results: = 0.123). In multivariate analysis, high EASIX scores, not performing autologous stem cell transplantation, and not receiving immunomodulatory therapy were identified as independent negative prognostic factors for survival. Conclusion: EASIX, especially mEASIX, is a valuable prognostic tool for predicting survival in MM patients. EASIX can be easily integrated into clinical practice due to its simple computability and reliance on commonly used laboratory parameters. However, larger prospective studies are needed to determine how these scores can be integrated with traditional prognostic systems such as the International Staging System (ISS) and Revised-ISS.