N‐terminal <scp>pro‐brain</scp> natriuretic peptide is a prognostic marker for response to intensive chemotherapy, early death, and overall survival in acute myeloid leukemia

Graf, Irene; Greiner, Georg; Marculescu, Rodrig; Gleixner, Karoline V.; Herndlhofer, Susanne; Stefanzl, Gabriele; Knoebl, Paul; Jäger, Ulrich; Hauswirth, Alexander W.; Schwarzinger, Ilse; Thalhammer, Renate; Kundi, Michael; Hoermann, Gregor; Mitterbauer-Hohendanner, Gerlinde; Valent, Peter; Sperr, Wolfgang R.

doi:10.1002/ajh.26805

Cited by 5 publications

(3 citation statements)

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“… 20 Besides cardiovascular toxicity risk stratification, monitoring, and diagnosis of cardiovascular complications, NT‐proBNP is also a prognostic marker for response to intensive chemotherapy, early death, and overall survival in cancer patients. 28 However, the utility of these biomarkers in the grading of iRC severity is yet to be studied. Besides, compared with NP, cTn, and GLS, NER is more accessible and economical as it can be calculated from routine bloodwork easily.…”

Section: Discussionmentioning

confidence: 99%

“…The 2022 ESC guidelines on cardio‐oncology recommend natriuretic peptides (NP), cardiac troponin (cTn), and global longitudinal strain (GLS) evaluation in all patients before cardiotoxic cancer treatment initiation to stratify cardiovascular risk and to identify significant changes during treatment 20 . Besides cardiovascular toxicity risk stratification, monitoring, and diagnosis of cardiovascular complications, NT‐proBNP is also a prognostic marker for response to intensive chemotherapy, early death, and overall survival in cancer patients 28 . However, the utility of these biomarkers in the grading of iRC severity is yet to be studied.…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity

et al. 2023

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Aims Inflammatory biomarkers, including CRP, the neutrophil‐to‐lymphocyte ratio (NLR), and the neutrophil‐to‐eosinophil ratio (NER), may predict outcomes in cancer. However, their value in immune checkpoint inhibitor (ICI) therapy‐associated cardiotoxicity remains elusive. We aimed to characterize the relationship of inflammatory markers with severity of ICI‐related cardiotoxicities (iRCs) and prognosis among patients with iRCs. Methods Patients who were diagnosed with iRCs between January 2019 and December 2021 were retrospectively enrolled and were dichotomized based on iRC severity into low‐grade (grade 1–2) vs. high‐grade (grade 3–4) groups. Results Forty‐seven patients were included. The median time‐to‐event from first ICI infusion to onset of iRCs was 35 days (IQR: 19.0–65.5 days). When compared with respective baseline values, cardiac biomarkers and inflammatory markers were significantly elevated at onset of iRCs. Compared with low‐grade iRCs, NER at iRC onset was significantly increased among patients with high‐grade iRCs (Group × Time, P < 0.01). When grouped by the median NER (184.33) at iRC onset, NER ≥ 184.33 was associated with high‐grade iRCs (OR: 10.77, P < 0.05) and had a 36.3% increased mortality compared to the lower NER group (HR: 2.67, P < 0.05). Conclusions In patients who develop iRCs, NER is significantly elevated at iRC onset, and higher NER correlates with greater iRC severity and higher mortality. Larger datasets are needed to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity

et al. 2023

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“…Comorbidities are evaluated using different scores able to identify patients who would not benefit from intensive chemotherapy [ 10 ], which could also be used to estimate patients’ outcomes [ 1 ]. Indeed, simple parameters such as NT-proBNP could be particularly helpful for identifying patients at higher risk of early mortality [ 11 ]. Frailty is better evaluated using geriatric-inspired assessment tools, which could capture weaknesses sometimes difficult to fully understand using clinical evaluation only [ 12 , 13 ].…”

Section: Clinical Risk Profilementioning

confidence: 99%

Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

Boscaro¹,

Urbino²,

Catania³

et al. 2023

Cancers

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An accurate estimation of AML prognosis is complex since it depends on patient-related factors, AML manifestations at diagnosis, and disease genetics. Furthermore, the depth of response, evaluated using the level of MRD, has been established as a strong prognostic factor in several AML subgroups. In recent years, this rapidly evolving field has made the prognostic evaluation of AML more challenging. Traditional prognostic factors, established in cohorts of patients treated with standard intensive chemotherapy, are becoming less accurate as new effective therapies are emerging. The widespread availability of next-generation sequencing platforms has improved our knowledge of AML biology and, consequently, the recent ELN 2022 recommendations significantly expanded the role of new gene mutations. However, the impact of rare co-mutational patterns remains to be fully disclosed, and large international consortia such as the HARMONY project will hopefully be instrumental to this aim. Moreover, accumulating evidence suggests that clonal architecture plays a significant prognostic role. The integration of clinical, cytogenetic, and molecular factors is essential, but hierarchical methods are reaching their limit. Thus, innovative approaches are being extensively explored, including those based on “knowledge banks”. Indeed, more robust prognostic estimations can be obtained by matching each patient’s genomic and clinical data with the ones derived from very large cohorts, but further improvements are needed.

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N‐terminal pro‐brain natriuretic peptide is a prognostic marker for response to intensive chemotherapy, early death, and overall survival in acute myeloid leukemia

et al. 2023

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Patient-related factors are of prognostic importance in acute myeloid leukemia (AML). Likewise, cardiac disorders may limit the tolerance of intensive therapy. Little is known about the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP). We analyzed NT-proBNP levels at diagnosis in 312 AML patients (median age: 61 years; range 17-89 years) treated with 3 + 7-based induction-chemotherapy and consolidation with up to four cycles of intermediate or high-dose ARA-C.NT-proBNP levels were elevated in 199 patients (63.8%), normal (0-125 pg/ml) in 113 (36.2%), and highly elevated (>2000 pg/ml) in 20 patients (6.4%). Median NT-proBNP levels differed significantly among patients with complete remission (153.3 pg/ml), no remission (225.9 pg/ml), or early death (735.5 pg/ml) (p = .002). In multivariate analysis, NT-proBNP, age, and the 2009 European LeukemiaNet (ELN-2009) classification were independent predictors of outcome after induction chemotherapy. Overall survival (OS) differed significantly between patients with normal, moderately elevated, and highly elevated NT-proBNP (p < .001). These differences were observed in all patients and in patients <60 years but not in those ≥60 years. In multivariate analysis, NT-proBNP, age, and ELN-2009 remained independent prognostic variables for OS (p < .01). Together, NT-proBNP is an independent prognostic factor indicating the risk of induction failure, early death, and reduced OS in patients with AML. | INTRODUCTIONAcute myeloid leukemia (AML) is a hematologic malignancy characterized by abnormal proliferation of neoplastic myeloid precursor cells and a maturation defect. 1,2 Despite the availability of curative chemotherapies and hematopoietic stem cell transplantation (HSCT), the prognosis in patients with AML remains poor. Death within the first 60 days after initiation of induction therapy is seen in a substantial

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N‐terminal pro‐brain natriuretic peptide is a prognostic marker for response to intensive chemotherapy, early death, and overall survival in acute myeloid leukemia

Cited by 5 publications

References 50 publications

Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity

Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor‐associated cardiotoxicity

Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

N‐terminal pro‐brain natriuretic peptide is a prognostic marker for response to intensive chemotherapy, early death, and overall survival in acute myeloid leukemia

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