The impact of pre-transplant fibrinogen and D-dimer levels on transplantation outcomes in autologous stem cell transplantation

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.