Smoking status in acute myeloid leukemia is associated with worse overall survival and independent of prior nonhematopoietic malignancies, cytogenetic abnormalities, and WHO category.

Autor: Kumar J; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065 United States. Electronic address: kumarj3@mskcc.org., Patel S; Department of Pharmacy, Stanford University School of Medicine, Stanford, CA, 94305 United States., Chang A; Department of Pharmacy, Stanford University School of Medicine, Stanford, CA, 94305 United States., Mukherjee S; Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States., Small C; Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States., Gollapudi S; Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States., Butzmann A; Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States., Jangam D; Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305 United States., Weinberg OK; Department of Pathology, University of Texas Southwestern, Dallas, TX, 75235 United States., George TI; Department of Pathology, University of Utah Health, Salt Lake City, UT, 84132 United States., Zehnder JL; Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305 United States., Ohgami RS; Department of Pathology, University of Utah Health, Salt Lake City, UT, 84132 United States.
Jazyk: angličtina
Zdroj: Human pathology [Hum Pathol] 2023 May; Vol. 135, pp. 45-53. Date of Electronic Publication: 2023 Mar 13.
DOI: 10.1016/j.humpath.2023.03.005
Abstrakt: Acute myeloid leukemia (AML) is an aggressive hematopoietic malignancy with several patient- and disease-associated variables known to impact prognosis. Tobacco smoking is an environmental factor associated with a greater incidence of AML, but there have been limited studies that evaluated smoking toward overall survival. We retrospectively searched for AML cases and collected clinical and diagnostic data for each case. We also used an independent next-generation sequencing (NGS) data set to assess for a distinct mutational signature associated with smoking. When stratified by smoking status, there was a greater number of males, patients aged ≥60 years, and patients with ≥2 comorbidities within the smoking category (P < .05). Survival analysis demonstrated decreased survival probability in the smokers, male smokers, smokers with 1 other comorbidity, and smokers without a prior history of nonhematopoietic malignancy (P < .05) as compared to nonsmokers. Smoking was associated with a decrease in survival within the World Health Organization categories of AML, not otherwise specified (AML NOS; P = .035) and AML with recurrent genetic abnormalities (AML RGA; P = .002). Multivariate analysis showed that patients who were smokers had a greater hazard ratio than nonsmokers after adjusting for the other covariates. Our findings demonstrated that smoking was independently associated with decreased overall survival after adjusting for other potentially confounding factors. In addition, our results suggest that a mutational signature can be recognized using NGS data in a subset of AML patients who smoke.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: