TY  - JOUR
T1  - The impact of pre-transplant fibrinogen and D-dimer levels on transplantation outcomes in autologous stem cell transplantation
TT  - Transplantasyon öncesi fibrinojen ve D-dimer düzeylerinin otolog kök hücre transplantasyonu sonuçlarına etkisi
AU  - Mandacı Şanlı, Neslihan
AU  - Mandacı, Edanur Dilara
PY  - 2025
DA  - July
Y2  - 2025
DO  - 10.32322/jhsm.1711682
JF  - Journal of Health Sciences and Medicine
JO  - J Health Sci Med /JHSM /jhsm
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2636-8579
SP  - 621
EP  - 628
VL  - 8
IS  - 4
LA  - en
AB  - Aims: Determine how serum D-dimer and fibrinogen levels affect the prognosis of patients undergoing autologous hematopoietic stem cell transplantation (auto-HSCT) within the context of underlying hematologic malignancies.Methods: This retrospective study included 152 adult patients who received auto-HSCT between 2010 and 2024. D-dimer and fibrinogen levels were documented prior to the transplant. Survival analyses were performed with Kaplan-Meier curves and Cox regression methods. ROC analysis provided cut-off values.Results: The D-dimer and fibrinogen cut-off levels of >860 ng/ml and >448 mg/dl, respectively, were statistically significant with increased rates of relapse and mortality. Mortality was independently predicted by D-dimer and fibrinogen (HR: 96.74 and 5.478) and relapse (HR: 24.254 and 6.921). Increased levels of the markers significantly reduced the five-year overall survival.Conclusion: Auto-HSCT patients with elevated D-dimer and fibrinogen have unfavorable prognoses and poor outcomes. The inexpensive nature of these biomarkers allows greater ease in establishing risk stratification for targeted pre-transplant planning.
KW  - Autologous stem cell transplantation
KW  - D-dimer
KW  - fibrinogen
KW  - prognosis
KW  - hematologic malignancy
N2  - Amaç: Bu çalışmada, hematolojik maligniteler bağlamında otolog hematopoetik kök hücre transplantasyonu (auto-HSCT) uygulanan hastalarda serum D-dimer ve fibrinojen düzeylerinin prognoz üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.Yöntemler: Bu retrospektif çalışmaya 2010 ile 2024 yılları arasında auto-HSCT uygulanan 152 yetişkin hasta dahil edilmiştir. Transplantasyon öncesi D-dimer ve fibrinojen düzeyleri kaydedilmiştir. Sağkalım analizleri Kaplan–Meier eğrileri ve Cox regresyon yöntemleriyle yapılmıştır. ROC analizi ile eşik değerler belirlenmiştir.Bulgular: D-dimer ve fibrinojen için sırasıyla >860 ng/mL ve >448 mg/dL eşik değerleri, artmış nüks ve mortalite oranları ile istatistiksel olarak anlamlı bulunmuştur. D-dimer ve fibrinojen düzeyleri mortalite (HR: 96.74 ve 5.478) ve nüks (HR: 24.254 ve 6.921) açısından bağımsız prediktörler olarak belirlenmiştir. Bu biyobelirteçlerin yüksek seviyeleri, beş yıllık genel sağkalım oranlarını anlamlı şekilde azaltmıştır.Sonuç: Yüksek D-dimer ve fibrinojen düzeylerine sahip auto-HSCT hastalarının prognozu olumsuzdur ve transplantasyon sonuçları kötüdür. Bu biyobelirteçlerin ucuz ve erişilebilir olması, transplantasyon öncesi risk sınıflaması yapılarak hedefe yönelik tedavi planlamasında kolaylık sağlar.
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UR  - https://doi.org/10.32322/jhsm.1711682
L1  - https://dergipark.org.tr/en/download/article-file/4925515
ER  -