title: Smoking adversely affects survival in acute myeloid leukemia patients.
abstract: Smoking adversely affects hematopoietic stem cell transplantation outcome. We asked whether smoking affected outcome of newly diagnosed acute myeloid leukemia (AML) patients treated with chemotherapy. Data were collected on 280 AML patients treated with high-dose cytarabine and idarubicin-containing regimens at Roswell Park Cancer Institute who had smoking status data at diagnosis. Patients' gender, age, AML presentation (de novo vs. secondary), white blood cell (WBC) count at diagnosis, karyotype and smoking status (never vs. ever) were analyzed. Among the 161 males and 119 females with a median follow-up of 12.9 months, 101 (36.1%) had never smoked and 179 (63.9%) were ever smokers. The proportion of patients between never and ever smokers was similar to respect to age, AML presentation, WBC count at diagnosis or karyotype based on univariate analysis of these categorical variables. Never smokers had a significantly longer overall survival (OS) (60.32 months) compared to ever smokers (30.89; p = 0.005). In multivariate analysis incorporating gender, age, AML presentation, WBC count, karyotype and smoking status as covariates, age, karyotype and smoking status retained prognostic value for OS. In summary, cigarette smoking has a deleterious effect on OS in AML.
authors.affiliation: Department of Medicine, Leukemia Section, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: Ramya
authors.initials: R
authors.lastname: Varadarajan
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Licht
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hyland
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Ford
authors.forename: Sheila N J
authors.initials: SN
authors.lastname: Sait
authors.forename: Annemarie W
authors.initials: AW
authors.lastname: Block
authors.forename: Maurice
authors.initials: M
authors.lastname: Barcos
authors.forename: Maria R
authors.initials: MR
authors.lastname: Baer
authors.forename: Eunice S
authors.initials: ES
authors.lastname: Wang
authors.forename: Meir
authors.initials: M
authors.lastname: Wetzler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D059785:Karyotype; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D015255:Idarubicin