History of drug use in allogeneic hematopoietic cell transplant recipients

A Correction to this article was published on 21 October 2020

This article has been updated

Abstract

Allogeneic hematopoietic cell transplant (HCT) is a curative therapy for malignant and non-malignant blood diseases. Drug use may be associated with adverse outcomes. We performed a retrospective analysis to assess non-relapse mortality (NRM) and overall survival (OS) in HCT patients with drug use. The medical charts of 232 patients were reviewed. Recipients of matched unrelated donor (MUD) or matched related donor (MRD) transplants were included. Drug use was defined by either metabolic evidence or provider documentation prior to transplant. Transplants were MUD (n = 148) or MRD (n = 84). Median follow-up duration was 15.5 months. There were 35 (15%) patients in the drug use group and 197 (85%) patients in the control group; 49% and 60.4% were in remission at the time of transplant, respectively. In univariate analysis, drug use was associated with a 3-year cumulative incidence of NRM of 43% vs 29% for the control group (p = 0.048), and an HR of 1.75, (95% CI: 1.02–2.99). After controlling for age, sex, disease status, and graft type, drug use was associated with a hazard ratio (HR) of 1.6 (95% CI: 0.95–2.92) for NRM, and an HR 1.2 (95% CI: 0.74–1.94) for OS. Larger cohorts may be needed to further evaluate this association.

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Fig. 1: Cumulative incidence of non-relapse mortality by illicit drug use at 3 years post-transplant.
Fig. 2: Kaplan–Meier estimations of overall survival for patients with a history of drug use compared to patients with no history of drug use.

Change history

  • 08 October 2020

    The original version of this Article contained an error in the presentation of the author name for Dr. Abou-Ismail. The first name was incorrectly published as Mouhamed instead of Mouhamed Yazan and the family name as Yazan Abou-Ismail instead of Abou-Ismail. This has now been corrected in both the PDF and HTML versions of the Article.

  • 21 October 2020

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Correspondence to Leland Metheny.

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Abou-Ismail, M.Y., Ravi, G., Fu, P. et al. History of drug use in allogeneic hematopoietic cell transplant recipients. Bone Marrow Transplant (2020). https://doi.org/10.1038/s41409-020-01058-z

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