title: A history of smoking is inversely correlated with the incidence of gemcitabine-induced neutropenia.
abstract: BACKGROUND
  Smoking may affect the efficacy of chemotherapy and the incidence of adverse events. We investigated the correlation between smoking history and gemcitabine-induced neutropenia.
  
  
  METHODS
  Data on smoking history and incidence of grade 3-4 neutropenia were retrospectively gathered for 103 chemo-naive patients treated with gemcitabine monotherapy (59 patients with pancreatic, 41 with hepatobiliary and three with other cancers).
  
  
  RESULTS
  There was a significantly higher incidence of grade 3-4 neutropenia among patients without a history of smoking (55.7%) than among those with a history of smoking (including current and ex-smokers; 23.6%) [odds ratio (OR) 0.244, 95% confidence interval (CI) 0.105-0.569; P < 0.001]. After adjustment for age, gender, platelet and baseline neutrophil counts, history of surgery for primary cancer, creatinine concentration, hemoglobin concentration, aspartate aminotransferase concentration, alanine aminotransferase concentration and total bilirubin concentration, logistic regression analysis identified a history of smoking as an independent inverse predictor of gemcitabine-induced neutropenia (OR 0.188, 95% CI 0.057-0.618; P = 0.006).
  
  
  CONCLUSIONS
  Patients without a history of smoking may be at higher risk of developing gemcitabine-induced neutropenia. The mechanism underlying this phenomenon is unclear at this point.
authors.affiliation: Outpatient Oncology Unit, Graduate School of Medicine, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan. kanai@kuhp.kyoto-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Kanai
authors.forename: S
authors.initials: S
authors.lastname: Morita
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Nishimura
authors.forename: E
authors.initials: E
authors.lastname: Hatano
authors.forename: S
authors.initials: S
authors.lastname: Yazumi
authors.forename: T
authors.initials: T
authors.lastname: Sasaki
authors.forename: H
authors.initials: H
authors.lastname: Yasuda
authors.forename: T
authors.initials: T
authors.lastname: Kitano
authors.forename: A
authors.initials: A
authors.lastname: Misawa
authors.forename: H
authors.initials: H
authors.lastname: Ishiguro
authors.forename: K
authors.initials: K
authors.lastname: Yanagihara
authors.forename: I
authors.initials: I
authors.lastname: Ikai
authors.forename: R
authors.initials: R
authors.lastname: Doi
authors.forename: M
authors.initials: M
authors.lastname: Fukushima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D001661:Biliary Tract Neoplasms / Q000097:blood / Q000188:drug therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000378:metabolism*; D010190:Pancreatic Neoplasms / Q000097:blood / Q000188:drug therapy; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000378:metabolism*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine