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

Ann Hematol. 2012 Dec;91(12):1929-35. doi: 10.1007/s00277-012-1529-8. Epub 2012 Jul 31.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers
  • Aged
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Leukemia, Myeloid, Acute / blood*
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / physiopathology
  • Leukemia, Myeloid, Acute / therapy
  • Lymphoproliferative Disorders / blood*
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / physiopathology
  • Lymphoproliferative Disorders / therapy
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / blood*
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / physiopathology
  • Myelodysplastic Syndromes / therapy
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Prognosis
  • ROC Curve
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Transplantation, Homologous

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain