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Post-Transplant Events

The impact of smoking on outcomes among patients undergoing hematopoietic SCT for the treatment of acute leukemia

Bone Marrow Transplantation volume 46, pages 285–290 (2011)Cite this article

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Abstract

A paucity of research exists examining the potential impact of tobacco use on cancer treatment outcomes, especially among patients treated with hematopoietic SCT (HSCT). A retrospective cohort study design was used to examine the impact of smoking on duration of hospitalization and overall survival among 148 consecutive patients undergoing HSCT for treatment of acute leukemia from 1999 to 2005. Of the 148 patients, 15% reported current smoking, 30% former smoking, and 55% never used tobacco. Patients were followed for a median 3.5 years (interquartile range=2.1–5.5). Compared to no history of smoking, current smoking was associated with worse pre-HSCT pulmonary function tests (P<0.02 in each case), more days hospitalization (46.2 days versus 25.7 days, P=0.025), and poorer overall survival (hazard ratio (HR)=1.88; 95% CI 1.09–3.25). Results were similar after multivariate adjustment, although the association with overall survival attenuated slightly (HR=1.75; 95% CI 1.00–3.06). Current smoking appears to adversely affect the number of days hospitalized post HSCT and overall survival. Translational research focused on interventions to promote tobacco cessation may lead to improved HSCT outcomes.

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Acknowledgements

We gratefully acknowledge the contributions of Norine Huneke, Lindsay Deling, Cameron Rismas, Carl Greiner, and Andrew Hanson for data collection and analysis support. We also acknowledge the Mayo Clinic Blood and Marrow Transplant Practice Group, who share day-to-day management responsibilities for patients and contribute to the data quality. This study was funded by a small grant from the Mayo Clinic Department of Psychiatry and Psychology and grant KL2 RR024151 from the National Institutes of Health (NIH).

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Authors and Affiliations

  1. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA

    S L Ehlers, C A Patten & S M Rausch

  2. Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA

    D A Gastineau & W J Hogan

  3. Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    P A Decker

  4. Department of Health Services Research, Mayo Clinic, Rochester, MN, USA

    J R Cerhan

  5. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    J O Ebbert & L F Porrata

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  1. S L Ehlers
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  2. D A Gastineau
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Correspondence to S L Ehlers.

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Ehlers, S., Gastineau, D., Patten, C. et al. The impact of smoking on outcomes among patients undergoing hematopoietic SCT for the treatment of acute leukemia. Bone Marrow Transplant 46, 285–290 (2011). https://doi.org/10.1038/bmt.2010.113

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  • DOI: https://doi.org/10.1038/bmt.2010.113

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