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Impact of cigarette smoking on survival after myeloablative allogeneic hematopoietic stem cell transplantation and contribution of invasive fungal infection

Bone Marrow Transplantation volume 52, pages 1665–1667 (2017)Cite this article

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Allogeneic hematopoietic stem cell transplantation (allo-HCT) is used to treat a variety of hematologic conditions. Many patient characteristics impact outcomes, including age, comorbidities, performance status and baseline respiratory function.1, 2 Cigarette smoking can influence these factors and therefore impact transplant eligibility, with the lifetime prevalence of smoking among patients who ultimately undergo hematopoietic stem cell transplant (HSCT) ranging from 22 to 62%.3, 4 Despite the well-established health implications of cigarette smoking on various diseases including cancer, only a limited number of studies have evaluated its impact on outcome following allo-HSCT.3, 4, 5, 6 In addition, tobacco cigarettes contain fungal elements that could potentially lead to invasive fungal infections (IFIs), which are considered among the most dangerous complications of allo-HSCT. While smoking has been reported to be associated with infectious pulmonary complications, the association with IFI remains unclear.5, 7 We therefore evaluated the hypothesis that heavy cigarette smoking was associated with worse allo-HSCT outcomes, with a focus on IFI.

We performed a retrospective analysis of 291 adult patients who received myeloablative allo-HCT for any indication at the Cleveland Clinic between January 2004 and December 2010. This study was reviewed and approved by the Cleveland Clinic Institutional Review Board and all patients had previously signed IRB-approved consent forms for research purposes. End points included relapse, relapse mortality, non-relapse mortality, overall survival (OS) and IFI.

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Authors and Affiliations

  1. Department of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA

    A Mehdi

  2. Quantitative Health Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA

    L Rybicki

  3. Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA

    S Mossad

  4. Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA

    M Yurch, M Sekeres, A T Gerds, D Jagadeesh, B Hamilton, H Liu, R Dean, B Pohlman, R Sobecks, S Andresen, M Kalaycio, B J Bolwell, N S Majhail & B T Hill

  5. Department of Hematology - Medical Oncology, Levine Cancer Center, Charlotte, NC, USA

    E Copelan

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  1. A Mehdi
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  2. L Rybicki
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  11. B Pohlman
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  16. N S Majhail
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  18. B T Hill
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Corresponding author

Correspondence to B T Hill.

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The authors declare no conflict of interest.

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Mehdi, A., Rybicki, L., Mossad, S. et al. Impact of cigarette smoking on survival after myeloablative allogeneic hematopoietic stem cell transplantation and contribution of invasive fungal infection. Bone Marrow Transplant 52, 1665–1667 (2017). https://doi.org/10.1038/bmt.2017.184

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