The effect of smoking on allogeneic transplant outcomes. Biol Blood Marrow Transplant 2009 Oct;15(10):1277-87
Date
09/15/2009Pubmed ID
19747636Pubmed Central ID
PMC2768519DOI
10.1016/j.bbmt.2009.06.005Scopus ID
2-s2.0-69749091932 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
Using the Center for International Blood and Marrow Transplant Research (CIBMTR) data, we compared the transplant outcomes of patients with chronic myelogenous leukemia (CML) who were nonsmokers (NS) and past or current smokers (PCS). There were 2193 NS and 625 PCS who received matched sibling and unrelated donor allografts for CML in first chronic phase. We looked for dose effects and identified low and high dose smoking groups (>10 pack years, >1 pack per day). Outcomes were adjusted for known prognostic variables including the European Group for Blood and Marrow Transplant (EBMT) risk score. In multivariate analyses of sibling allograft recipients, relapse risk (RR) was higher (RR=1.67, P=.003) in smokers than NS, but the dose effects were not consistent. High-dose smokers experienced a 50% treatment-related mortality (TRM) versus 28% in the NS group at 5 years on univariate analysis, and the RR was 1.57 (P=.005) on multivariate analysis. Overall survival (OS) at 5 years was 68% in NS versus 62% in the low-dose smoking group versus 50% in the high-dose smoking group (P < .001). Smoking did not significantly affect outcomes in unrelated donor recipients, but numbers were smaller. High-dose smoking is associated with a reduction in OS in patients having sibling allografts for CML. A prospective study with detailed demographic, pulmonary function, and quality-of-life data would improve our understanding of this issue.
Author List
Marks DI, Ballen K, Logan BR, Wang Z, Sobocinski KA, Bacigalupo A, Burns LJ, Gupta V, Ho V, McCarthy PL, Ringdén O, Schouten HC, Seftel M, Rizzo JDAuthors
Brent R. Logan PhD Director, Professor in the Data Science Institute department at Medical College of WisconsinJ. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Bone Marrow Transplantation
Disease-Free Survival
Female
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Living Donors
Male
Middle Aged
Recurrence
Retrospective Studies
Risk Factors
Siblings
Smoking
Survival Rate
Transplantation, Homologous