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Substance abuse and bone marrow transplant.

Abstract

The purpose of this retrospective study is to test the hypothesis that lifetime substance abuse has an adverse impact on survival after bone marrow transplant (BMT). This study included 17 of 468 patients admitted to the Bone Marrow Transplant Unit at the Brigham and Women's Hospital in Boston, Massachusetts who were identified to have lifetime substance abuse (SA). Seventeen comparison subjects were selected from the admissions roster if they matched for disease and stage, type of transplant, pretransplant conditioning regimen, and age, but did not have SA. The medical records of all 34 patients were then reviewed by expert substance abuse clinicians for confirmation of SA and course of transplant. Survival time was calculated from the date of BMT admission to the date of last contact. Survival data were analyzed through Kaplan Meier survival curves and log rank tests for association of survival time with lifetime SA, both before and after stratification for history of cigarette smoking and type of transplant. The patients with and without SA were well matched for all clinical factors. Substance abuse or dependence was confirmed in all 17 patients, with alcohol (71%), marijuana (30%), and opiates (30%) identified as the principal substances of abuse. Survival analysis demonstrated reduced survival times for patients with SA, p = .0022. This difference persisted after stratifying for type of transplant and cigarette smoking. Trends in different survival times by type of transplant (p = .054) and by history of cigarette smoking (p = .07) were also identified. Lifetime substance abuse or dependence appears to have an adverse association with survival after bone marrow transplant when other clinical factors are equal.

Authors+Show Affiliations

,

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

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Source

MeSH

Adult
Alcoholism
Benzodiazepines
Bone Marrow Transplantation
Cocaine
Female
Humans
Leukemia
Male
Marijuana Abuse
Middle Aged
Narcotics
Retrospective Studies
Smoking
Substance-Related Disorders
Survival Analysis

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9143640

Citation

Chang, G, et al. "Substance Abuse and Bone Marrow Transplant." The American Journal of Drug and Alcohol Abuse, vol. 23, no. 2, 1997, pp. 301-8.
Chang G, Antin JH, Orav EJ, et al. Substance abuse and bone marrow transplant. Am J Drug Alcohol Abuse. 1997;23(2):301-8.
Chang, G., Antin, J. H., Orav, E. J., Randall, U., McGarigle, C., & Behr, H. M. (1997). Substance abuse and bone marrow transplant. The American Journal of Drug and Alcohol Abuse, 23(2), pp. 301-8.
Chang G, et al. Substance Abuse and Bone Marrow Transplant. Am J Drug Alcohol Abuse. 1997;23(2):301-8. PubMed PMID: 9143640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Substance abuse and bone marrow transplant. AU - Chang,G, AU - Antin,J H, AU - Orav,E J, AU - Randall,U, AU - McGarigle,C, AU - Behr,H M, PY - 1997/5/1/pubmed PY - 1997/5/1/medline PY - 1997/5/1/entrez SP - 301 EP - 8 JF - The American journal of drug and alcohol abuse JO - Am J Drug Alcohol Abuse VL - 23 IS - 2 N2 - The purpose of this retrospective study is to test the hypothesis that lifetime substance abuse has an adverse impact on survival after bone marrow transplant (BMT). This study included 17 of 468 patients admitted to the Bone Marrow Transplant Unit at the Brigham and Women's Hospital in Boston, Massachusetts who were identified to have lifetime substance abuse (SA). Seventeen comparison subjects were selected from the admissions roster if they matched for disease and stage, type of transplant, pretransplant conditioning regimen, and age, but did not have SA. The medical records of all 34 patients were then reviewed by expert substance abuse clinicians for confirmation of SA and course of transplant. Survival time was calculated from the date of BMT admission to the date of last contact. Survival data were analyzed through Kaplan Meier survival curves and log rank tests for association of survival time with lifetime SA, both before and after stratification for history of cigarette smoking and type of transplant. The patients with and without SA were well matched for all clinical factors. Substance abuse or dependence was confirmed in all 17 patients, with alcohol (71%), marijuana (30%), and opiates (30%) identified as the principal substances of abuse. Survival analysis demonstrated reduced survival times for patients with SA, p = .0022. This difference persisted after stratifying for type of transplant and cigarette smoking. Trends in different survival times by type of transplant (p = .054) and by history of cigarette smoking (p = .07) were also identified. Lifetime substance abuse or dependence appears to have an adverse association with survival after bone marrow transplant when other clinical factors are equal. SN - 0095-2990 UR - https://www.unboundmedicine.com/medline/citation/9143640/Substance_abuse_and_bone_marrow_transplant_ L2 - https://medlineplus.gov/bonemarrowtransplantation.html DB - PRIME DP - Unbound Medicine ER -