title: Cigarette smoking, blast crisis, and survival in chronic myeloid leukemia.
abstract: We reviewed the records of all patients with chronic myeloid leukemia (CML) seen in the CML Clinic of the University of Colorado Health Sciences Center between 1968 and 1987 for a history of cigarette smoking. Patients who smoked for five or more pack/years within the ten years preceding, or after the diagnosis of CML, were defined as smokers. Adequate smoking histories were obtained on 122 patients. Eighty-seven of these were non-smokers and 35 were smokers by the above criteria. The smoking group had a higher predominance of males, an older median age, and were diagnosed earlier in the course of the 20 year study. Seventy-two patients had died at the time of analysis. All but one, a non-smoker, died from the development of blast crisis. The overall median actuarial survival was significantly reduced for smokers (35 months) as compared to non-smokers (47 months). This was particularly striking for patients who had succumbed to the disease, with a median survival of 30 months in smokers versus 46 months in non-smokers. Although various explanations could explain the differences noted, we conclude that cigarette smoking has an adverse effect on the development of blast crisis and survival in chronic myeloid leukemia.
authors.affiliation: Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
authors.forename: R
authors.initials: R
authors.lastname: Herr
authors.forename: J
authors.initials: J
authors.lastname: Ferguson
authors.forename: N
authors.initials: N
authors.lastname: Myers
authors.forename: D
authors.initials: D
authors.lastname: Rovira
authors.forename: W A
authors.initials: WA
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001752:Blast Crisis / Q000209:etiology* / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012744:Sex Ratio; D012907:Smoking / Q000009:adverse effects*