title: NT-pro-BNP: not the prognostic all-rounder in elderly patients undergoing allogeneic stem cell transplantation.
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.
authors: Department of Hematology and Oncology, Freiburg University Medical Center, Freiburg, Germany. peter.haas@uniklinik-freiburg.de
authors: Peter S
authors: PS
authors: Haas
authors: Gabriele
authors: G
authors: Ihorst
authors: Susanne
authors: S
authors: Schnitzler
authors: Ralph
authors: R
authors: Wäsch
authors: Reinhard
authors: R
authors: Marks
authors: Hartmut
authors: H
authors: Bertz
authors: Roland
authors: R
authors: Mertelsmann
authors: Jürgen
authors: J
authors: Finke
authors: Barbara
authors: B
authors: Deschler
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain