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Influence of cigarette smoking on the presentation and course of chronic myelogenous leukemia
Author(s) -
Archimbaud Eric,
Maupas Jean,
LecluzePalazzolo Catherine,
Fiere Denis,
Viala JeanJacques
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890515)63:10<2060::aid-cncr2820631031>3.0.co;2-2
Subject(s) - medicine , chronic myelogenous leukemia , leukemia , presentation (obstetrics) , course (navigation) , surgery , physics , astronomy
It is known that cigarette smoking induces leukocytosis and increased genetic instability in normal individuals. Therefore, a retrospective review was conducted of 173 patients with chronic myelogenous leukemia to detect a possible influence of cigarette smoking on initial characteristics at the time of presentation and on the course of this disease. Thirty‐nine patients (23%) were smoking 5 cigarettes/d or more at time of diagnosis. Cigarette smoking was significantly related to male sex ( P = 0.0005) and younger age at diagnosis ( P = 0.02) and smokers tended to have lower leukocyte counts ( P = 0.07) than nonsmokers. Cigarette smoking was significantly associated with early blast crisis ( P < 0.0001) and short survival ( P < 0.0001). Other characteristics associated with a poor prognosis included hepatomegaly, anemia, and a high percentage of peripheral blast cells at time of diagnosis. When studied in a multivariate analysis, cigarette smoking remained the strongest prognostic factor for both occurrence of blast crisis ( P = 0.0003) and overall survival ( P = 0.0001). Other poor prognosis factors found in the multivariate analysis included a high percentage of blasts in the peripheral blood at time of diagnosis and high platelet count. It is possible that cigarette smoke may act as a promoter or cocarcinogen in the transformation of chronic myelogenous leukemia.