Smoking tied to inferior survival in acute myeloid leukemia

Smoking status is an important patient-related prognostic factor for outcome in patients with acute myeloid leukemia (AML) treated with intensive chemotherapy, according to a study published online April 21 in the British Journal of Haematology.

Daniel Kristensen, M.D., from Aalborg University Hospital in Denmark, and colleagues conducted a nationwide cohort study based on data from the Danish National Leukaemia Registry to examine the prognostic impact of smoking status in patients with AML treated with intensive chemotherapy. Data were included for 1,040 patients diagnosed with AML between Jan. 1, 2000, and Dec. 31, 2012; of these patients, 58.9 percent were classified as ever-smokers.

The researchers found that ever-smokers had a significantly shorter median overall survival compared with never-smokers (17.2 versus 24.5 months). Smoking status was a significant prognostic factor for inferior overall survival in a multivariate analysis (hazard ratio, 1.22).

“Due to the observational and hypothesis-generating character of this study, it remains uncertain whether tobacco-smoking affects overall survival in patients with AML through leukemia-related (e.g., somatic mutations) or patient-related (e.g., pulmonary morbidity) factors,” the authors write. “We suggest that future studies on this subject should aim to include socio-economic and leukemia-related prognostic factors to study the exact mechanism of inferior survival in previous and current smokers with AML.”

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