Patients at risk: addressing addiction in patients undergoing hematopoietic SCT

Addictive disorders are common and underdiagnosed in the general medical population. While it is well recognized that alcohol consumption is linked to cancers of the head and neck as well as the large bowel, its association with cancers for which hematopoietic SCT (HSCT) is a modality of treatment is not as clear. Further, the complications of alcohol or other drug addiction in patients undergoing HSCT has not been well studied. However, patients with comorbid substance use disorders (SUDs) are at higher risk for morbidity and mortality while undergoing HSCT due to medical sequelae of SUDs and issues of social support, adherence to treatment plans, and impairment of judgment and decision-making. Behavioral patterns of patients with SUDs are clearly relevant factors to consider in patient selection, management and outcome. We offer a review of the existing literature and recommendations for assessment and management of this patient population.