Annals of Hematology

, Volume 91, Issue 12, pp 1929–1935

NT-pro-BNP: not the prognostic all-rounder in elderly patients undergoing allogeneic stem cell transplantation

  • Peter S. Haas
  • Gabriele Ihorst
  • Susanne Schnitzler
  • Ralph Wäsch
  • Reinhard Marks
  • Hartmut Bertz
  • Roland Mertelsmann
  • Jürgen Finke
  • Barbara Deschler
Original Article

DOI: 10.1007/s00277-012-1529-8

Cite this article as:
Haas, P.S., Ihorst, G., Schnitzler, S. et al. Ann Hematol (2012) 91: 1929. doi:10.1007/s00277-012-1529-8

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.

Keywords

ElderlyPro-BNPRisk assessmentAllogeneic HCT

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Peter S. Haas
    • 1
  • Gabriele Ihorst
    • 2
  • Susanne Schnitzler
    • 1
  • Ralph Wäsch
    • 1
  • Reinhard Marks
    • 1
  • Hartmut Bertz
    • 1
  • Roland Mertelsmann
    • 1
  • Jürgen Finke
    • 1
  • Barbara Deschler
    • 1
  1. 1.Department of Hematology and OncologyFreiburg University Medical CenterFreiburgGermany
  2. 2.Clinical Trials UnitFreiburg University Medical CenterFreiburgGermany