1. NT-pro-BNP: not the prognostic all-rounder in elderly patients undergoing allogeneic stem cell transplantation.
- Author
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Haas PS, Ihorst G, Schnitzler S, Wäsch R, Marks R, Bertz H, Mertelsmann R, Finke J, and Deschler B
- Subjects
- Academic Medical Centers, Aged, Biomarkers blood, Cohort Studies, Female, Follow-Up Studies, Humans, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute physiopathology, Leukemia, Myeloid, Acute therapy, Lymphoproliferative Disorders diagnosis, Lymphoproliferative Disorders physiopathology, Lymphoproliferative Disorders therapy, Male, Middle Aged, Myelodysplastic Syndromes diagnosis, Myelodysplastic Syndromes physiopathology, Myelodysplastic Syndromes therapy, Prognosis, ROC Curve, Recurrence, Retrospective Studies, Survival Analysis, Transplantation, Homologous, Hematopoietic Stem Cell Transplantation adverse effects, Leukemia, Myeloid, Acute blood, Lymphoproliferative Disorders blood, Myelodysplastic Syndromes blood, Natriuretic Peptide, Brain blood, Peptide Fragments blood
- Abstract
Allogeneic hematopoietic cell transplantation (HCT) is a curative approach for several diseases predominantly affecting elderly patients. Overall survival is compromised by treatment-related mortality (TRM), GvHD, and relapse. Pretransplant clinical risk indicators in elderly patients qualifying for HCT are highly desirable. Pro-BNP is known as a predictor of death in patients with an increasing variety of clinical conditions and frequently used as a routine parameter for organ complications in the allogeneic transplant setting without well-established scientific evidence. Our hypothesis was that pre-HCT NT-pro-BNP could aid in identifying elderly patients at risk for early mortality. We retrospectively evaluated NT-pro-BNP values in 177 consecutive patients of ≥60 years HCT (2005-2010). In 29.4 % of cases, NT-pro-BNP values were within our institute's normal range (<125 pg/ml). Analysis of different NT-pro-BNP cutoff points by receiver operating characteristics curve for mortality at day +100 revealed no single cutoff value with satisfying specificity and sensitivity. The individual outcome of patients with extremely high NT-pro-BNP values was not associated with an increase in mortality or cardiovascular morbidity. NT-pro-BNP values of patients succumbing to TRM did not differ significantly from those alive or having died of relapse-median 276 vs. 217 pg/ml. In conclusion, pre-HCT NT-pro-BNP was of no convincing prognostic relevance for day 100 mortality.
- Published
- 2012
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