Abstract
Early mortality in acute myeloid leukemia (AML) remains a clinical challenge, yet robust, simple predictors are lacking. This study evaluates the prognostic value of the Endothelial Activation and Stress Index (EASIX), calculated using LDH, creatinine, and platelets, for predicting early fatal complications in newly diagnosed (ND) AML. We conducted a retrospective single-center cohort study of 158 adult patients with ND AML treated with intensive induction chemotherapy. The EASIX score was calculated at diagnosis (day 1). The co-primary endpoints were ICU admission and death from any cause within 3 months. The median log2-EASIX was 2.10. Hish-risk patients (upper quartile, threshold 3.53) had significantly higher 3-month mortality (32.5% vs. 5.1%, p < 0.001) and ICU admission rates (50% vs. 19.6%, p < 0.001). In multivariate analysis, high EASIX was an independent predictor of 3-month mortality (OR 6.60; 95% CI 1.93–22.50) and ICU admission (OR 4.05, 95% CI 1.63–10.05). The EASIX score is a simple tool that predicts early adverse outcomes in ND AML. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-026-07031-y.