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Substance abuse and bone marrow transplant

G Chang1, J H Antin, E J Orav

  • 1Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. GChang@Bics.BWH.Harvard.edu

The American Journal of Drug and Alcohol Abuse
|May 1, 1997
PubMed
Summary

Lifetime substance abuse negatively impacts survival rates for patients undergoing bone marrow transplant (BMT). This finding held true even after accounting for factors like smoking and transplant type.

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Area of Science:

  • Hematology
  • Oncology
  • Addiction Medicine

Background:

  • Bone marrow transplant (BMT) is a critical treatment for various hematologic and oncologic conditions.
  • The long-term outcomes of BMT can be influenced by patient-specific factors, including substance abuse history.
  • Understanding the impact of substance abuse on BMT survival is crucial for comprehensive patient care.

Purpose of the Study:

  • To investigate the association between lifetime substance abuse (SA) and survival outcomes in patients following bone marrow transplant (BMT).
  • To test the hypothesis that a history of substance abuse adversely affects survival post-BMT.

Main Methods:

  • Retrospective study comparing 17 BMT patients with lifetime substance abuse to 17 matched controls without SA.
  • Patients were matched for disease, transplant type, conditioning regimen, and age.

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  • Survival analysis utilized Kaplan-Meier curves and log-rank tests, with stratification for smoking and transplant type.
  • Main Results:

    • Substance abuse was confirmed in all 17 patients, with alcohol, marijuana, and opiates being the most common substances.
    • Patients with a history of substance abuse demonstrated significantly reduced survival times post-BMT (p = .0022).
    • This adverse association persisted after controlling for cigarette smoking and transplant type.

    Conclusions:

    • Lifetime substance abuse is linked to poorer survival outcomes in bone marrow transplant recipients.
    • These findings highlight the importance of addressing substance abuse in BMT patient management.
    • Further research may explore interventions to mitigate the negative impact of substance abuse on BMT survival.