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

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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.

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Acknowledgments

This project was supported by the Deutsche Krebshilfe with a grant 108467 to BD.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Freiburg University Medical Center, Freiburg, Germany

    Peter S. Haas, Susanne Schnitzler, Ralph Wäsch, Reinhard Marks, Hartmut Bertz, Roland Mertelsmann, Jürgen Finke & Barbara Deschler

  2. Clinical Trials Unit, Freiburg University Medical Center, Freiburg, Germany

    Gabriele Ihorst

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  1. Peter S. Haas
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Correspondence to Peter S. Haas.

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Haas, P.S., Ihorst, G., Schnitzler, S. et al. NT-pro-BNP: not the prognostic all-rounder in elderly patients undergoing allogeneic stem cell transplantation. Ann Hematol 91, 1929–1935 (2012). https://doi.org/10.1007/s00277-012-1529-8

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  • DOI: https://doi.org/10.1007/s00277-012-1529-8

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