Smoking impairs molecular response, and reduces overall survival in patients with chronic myeloproliferative neoplasms: A retrospective cohort study

Abstract

Summary The effects of smoking on the molecular response (MR) and overall survival (OS) in patients with chronic myeloproliferative neoplasms (MPNs) have not been investigated before. We analysed a historical cohort of 498 consecutive patients diagnosed with MPNs. Moreover, we analysed a subgroup of 270 consecutive patients with MPNs with > 1 measurement of the JAK2V617F variant allele frequency. The data were analysed using Kaplan–Meier plots and Cox regression analysis, along with linear regression models. In all patients, the rate of MR was significantly higher in never‐smokers compared with current smokers in the univariate model (HR, 1·9; 95% CI, 1·1–3·3; P = 0·033) and the multivariate model (HR, 1·9; 95% CI, 1·1–3·5; P = 0·029). Similar findings were observed with different cut‐off values for a partial MR. A subgroup analysis including only interferon‐α2‐treated patients showed similar results. In multivariate analyses, the OS was significantly better for never‐smokers (HR, 0·46; 95% CI, 0·29–0·75; P = 0·002) than current smokers. The differences were more pronounced in the pegylated interferon‐α2‐treated patients. However, no significant interaction of interferon‐α2 treatment was observed. In conclusion, we found that tobacco smoking reduced the rate of MR and OS in patients with MPNs. Cessation of smoking should be encouraged.

New Perspectives of Interferon-alpha2 and Inflammation in Treating Philadelphia-negative Chronic Myeloproliferative Neoplasms

“…A recent study has shown that smoking impairs molecular response and reduces overall survival in MPN patients treated with rIFNα. 41…”

“…A recent study has shown that smoking impairs molecular response and reduces overall survival in MPN patients treated with rIFNα. 41 What are the reasons for rIFNα resistance or intolerance in the MPNs?…”

“…Since smoking may be a likely trigger and driver of clonal evolution in patients with an MPN and since smoking, per se, gives rise to erythrocytosis, leukocytosis, and sometimes thrombocytosis, 37 it increases the thrombotic risk associated with an MPN. A recent study has shown that smoking impairs molecular response and reduces overall survival in MPN patients treated with rIFNα 41 …”

Hip and Knee Osteoarthritis in Patients with Chronic Myeloproliferative Neoplasms: A Cross-Sectional Study

“…The controversy regarding the effect of smoking on sOA development and progression indeed exists [ 73 , 74 , 75 ], and studies on larger numbers of MPN patients are needed to clarify whether smoking has an effect on OA development in MPN patients. This may be even more important in light of the recent findings indicating that smoking may be responsible for MPN development, lower treatment responses, and impaired survival [ 76 , 77 ].…”

Analysis of the Clinical Significance and Safety of Interferon in the Treatment of Chronic Myeloproliferative Tumors

“…Li et al [ 14 ] found that the gene load of JAK2V617F mutation in patients with MPN was closely related to the severity and duration of the disease. Zhang et al [ 15 ] found that IFN- α specifically blocked the proliferation advantage of JAK2V617F mutant hematopoietic stem cells in mice, thereby preventing the development of MPN and even achieving eradication [ 16 ]. Clinical research has reported that some patients with MPN treated with IFN achieved complete hematologic and molecular biological remission [ 17 ].…”