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3743 NT-ProBNP Is the Strongest Prognostic Factor for Survival in Lymphoma Patients Following Treatment with Curative Intent

Monday, December 8, 2008, 5:30 PM-7:30 PM
Hall A (Moscone Center)
Poster Board III-825

Antonio Salar, MD, PhD1*, Blanca Sanchez-Gonzalez, MD, PhD1*, Alberto Alvarez-Larrán, MD1*, Josep Comin, MD2*, Carmen Pedro, MD1*, Eva Gimeno, MD1*, Miquel Gómez, MD2*, Eugenia Abella, MD1*, Lluis Molina, MD, PhD2*, Franscesc Garcia1*, Jordi Bruguera2* and Carlos Besses, MD, PhD1*

1Hematology Department, Hospital del Mar, Barcelona, Spain
2Cardiology, Hospital del Mar, Barcelona, Spain

Introduction: High blood levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), a sensitive indicator of cardiac abnormalities, have been associated with poor outcome in patients with amyloidosis. However, its clinical value in lymphoma is unknown.
Aim: To assess the value of NT-proBNP as a prognostic variable for survival in patients with lymphoma treated with chemotherapy with curative intent.
Patients and methods: Clinical heart examination, evaluation of cardiovascular risk factors, determination of NT-proBNP (ECLIA; Roche) blood levels and high resolution ultrasound echocardiography were done at diagnosis. Clinical variables related with patient characteristics, lymphoma risk and cardiovascular risk were analyzed.
Results: 117 consecutive pts have been analyzed: median age: 63 years (range: 18-88); male: 56%; NHL: 80%; HL: 20%; ECOG/PS ≥2: 29%; III-IV: 56%; B-symptoms: 16%; LDH >1 nv: 34%; b2-microglobulin >1 nv: 57%; albumin <35 g/L: 32%; haemoglobin <105 g/L: 25%; extranodal ≥2: 20%; number of comorbidities ≥2: 51%; previous cardiac disease: 10%; median NT-proBNP: 107 pg/mL (4-9102); median left ventricular ejection fraction (LVEF): 66% (41-83). High blood levels of NT-proBNP were associated with previous cardiologic history but not with LVEF. With a median follow-up of 15.8 moths (0.2-48.9), 16 patients died. Overall survival (OS) at 24 months was 84% (95% CI: 77-91%). In the univariate analysis, factors associated with worse OS were: NT-proBNP >900, ECOG/PS ≥2, LDH >1 nv, b2-microglobulin >1 nv, albumin < 35 g/L, haemoglobin <105 g/L, comorbidities ≥2, previous cardiologic history, extranodal sites ≥2, age >60. In multivariate analysis, factors predicting for survival were NT-proBNP >900 (HR 15, 95%CI: 3.9-57.8) (p<0.0001) and ECOG/PS ≥2.(HR 4.1, 95%CI: 1.1-16.3) (p=0.04).
Conclusions:  1) NT-proBNP >900 pg/mL is the strongest prognostic factor for survival in patients with lymphoma following treatment with curative intent. 2) NT-proBNP is an easy, fast, widely available and well-standardized parameter that could be useful in addition to other well-established prognostic indexes.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH