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Clinical impact of cigarette smoking on the outcomes of allogeneic hematopoietic stem cell transplantation: a multicenter retrospective study

Bone Marrow Transplantation volume 57, pages 1124–1132 (2022)Cite this article

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Abstract

Smoking is associated with a high risk for different diseases including respiratory tract infections in immunocompetent patients. However, data about the effects of cigarette smoking on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are limited. Therefore, we retrospectively investigated 608 patients aged ≥20 years with hematological disorders who received their first allo-HSCT at our group of hospitals between 2000 and 2015, and evaluated the impact of cigarette smoking before allo-HSCT on clinical outcomes by dividing patients into two groups according to the Brinkman index (BI) (nonsmokers or light smokers [BI: 0–500] and heavy smokers [BI: ≥ 500]). Multivariate analyses showed that heavy smoking was associated with a high 5-year cumulative incidence of chronic graft-versus-host disease (cGVHD) (hazard ratio [HR]: 1.73, 95% confidence interval [CI]: 1.15–2.61, p < 0.01). The 5-year overall survival (HR: 1.16, 95% CI: 0.86–1.58, p = 0.33) and disease-free survival (HR: 1.12, 95% CI: 0.83–1.52, p = 0.45) were similar between the two groups. Hence, cigarette smoking is correlated with cGVHD, although prospective studies must be conducted to further verify this result.

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Fig. 1: PFT results at pretransplantation and 1 year post transplantation.
Fig. 2: Survival probability and cumulative incidence of relapse and GVHD.

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Data availability

The data supporting the results of this study are available from the corresponding author upon a reasonable request.

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Acknowledgements

We would like to thank the medical staff at the Yokohama City University Medical Center, Yokohama City University School of Medicine, and Kanagawa Cancer Center for their excellent patient care.

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Authors and Affiliations

  1. Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan

    Takuma Ohashi, Jun Aoki, Yoshimi Ishii, Kazuho Miyashita, Yuki Nakajima & Shin Fujisawa

  2. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Taiki Ando, Yasufumi Ishiyama, Takayoshi Tachibana, Masatsugu Tanaka & Heiwa Kanamori

  3. Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan

    Maki Hagihara, Kenji Matsumoto & Hideaki Nakajima

Authors
  1. Takuma Ohashi
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  2. Jun Aoki
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  3. Taiki Ando
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  4. Yasufumi Ishiyama
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  5. Yoshimi Ishii
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  11. Masatsugu Tanaka
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  13. Shin Fujisawa
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  14. Hideaki Nakajima
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Yokohama Cooperative Study Group for Hematology (YACHT)

Contributions

We gratefully acknowledge the contributions of all co-authors for data collection and analysis support. All authors critically revised the report, commented on drafts of the manuscript, and approved the final report.

Corresponding author

Correspondence to Shin Fujisawa.

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Competing interests

TT received personal fees from Otsuka, Novartis, Pfizer, BMS, Daiichi Sankyo, and Astellas, outside the submitted study. SF received research funding from Takeda Pharmaceutical and Otsuka Pharmaceutical. HN received research funding from Daiichi-Sankyo, Chugai Pharmaceuticals, Astellas, Asahikasei pharma, Takeda pharmaceuticals, Pfizer and Eizai, honoraria from Novartis and Daiichi Sankyo.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki and the Ethics Guidelines for Clinical Research published by the Ministry of Health, Labor, and Welfare of Japan. This retrospective study was approved by Ethical Committee for Medical and Biological Research Involving Human Subjects of Yokohama City University Medical Center (B180800006). Approval for the protocol and written informed consent forms were obtained from the ethics committees at each institution. The written decision can be presented upon request.

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Ohashi, T., Aoki, J., Ando, T. et al. Clinical impact of cigarette smoking on the outcomes of allogeneic hematopoietic stem cell transplantation: a multicenter retrospective study. Bone Marrow Transplant 57, 1124–1132 (2022). https://doi.org/10.1038/s41409-022-01678-7

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