Smoking Intensifies Genetic Mutations and Accelerates Progression in Myelodysplastic Syndromes
New research highlights a concerning link between tobacco smoking and myelodysplastic syndromes (MDS), a group of cancers affecting blood cell production. Researchers found that smokers with MDS displayed a higher frequency of mutations, particularly mutations associated with aggressive disease progression, compared to their non-smoking counterparts. The study, presented at the 2024 American Society of Hematology (ASH) Annual Meeting, sheds light on the detrimental effects of smoking on MDS development and underlines the importance of smoking cessation for patients diagnosed with this disorder.
"This study strongly suggests that tobacco smoking plays a substantial role in the development and progression of MDS," said Sangeetha Venugopal, MD, MS, lead researcher and physician at the Sylvester Comprehensive Cancer Center at the University of Miami. "Our findings carry a clear message for both patients and healthcare professionals: stopping smoking is essential for managing MDS and slowing disease progression."
The research team delved into the vast data from The National Myelodysplastic Syndromes Natural History Study, the largest study of its kind to date. This comprehensive database provided granular-level insights into patients’ diagnostic history, medical background, genetic profiles, and treatment outcomes. By analyzing data from 1,898 MDS patients, approximately half of whom were smokers, the researchers uncovered a compelling correlation between smoking intensity and disease severity.
Smokers exhibited a significantly higher prevalence of specific gene mutations known to be implicated in MDS progression. Notably, mutations in genes like ASXL1, SF3B1, U2AF1, and ZRSR2 were more common in smokers, indicating a more aggressive and potentially challenging disease course.
The researchers also observed a direct relationship between the number of pack-years smoked and the rate of genetic mutations. Pack-years, a measure of cumulative cigarette consumption (packs smoked per day multiplied by years smoked), served as a gauge of smoking intensity. Patients who smoked for longer durations or consumed more cigarettes per day displayed a higher mutation burden, further emphasizing the detrimental impact of smoking on MDS development.
This dose-response relationship extended to disease progression and overall survival.
Smokers, particularly those with long-term and heavy smoking histories, experienced a significantly higher 5-year cumulative incidence of disease progression compared to non-smokers.
Moreover, patients with clonal cytopenia of undetermined significance (CCUS), often considered a precursor to MDS, who smoked had a lower overall survival rate compared to their non-smoking counterparts.
These findings underscore the importance of smoking cessation counseling for individuals diagnosed with MDS or CCUS. Quitting smoking, even after diagnosis, can significantly mitigate the risk of disease progression, improve treatment outcomes, and enhance overall survival.
"These results strongly advocate for proactive smoking cessation interventions for MDS patients," Venugopal emphasized. "Encouraging patients to quit smoking, regardless of disease stage, can potentially slow disease progression and offer them a better chance at a longer and healthier life."
What specific gene mutations were found to be more prevalent in smokers with MDS?
## Interview: Smoking and Myelodysplastic Syndromes
**Host:** Welcome back to the show. Today we’re discussing a groundbreaking new study linking smoking to the progression of Myelodysplastic Syndromes, a group of blood cancers. Joining us today is Dr. Sangeetha Venugopal, lead researcher and physician at the Sylvester Comprehensive Cancer Center at the University of Miami, who presented these findings at this year’s ASH Annual Meeting. Dr. Venugopal, thank you for being here.
**Dr. Venugopal:** Thank you for having me.
**Host:** Your study suggests a strong link between smoking and MDS progression. Can you tell us more about what you discovered?
**Dr. Venugopal:** Absolutely. We analyzed a large dataset from the National Myelodysplastic Syndromes Natural History Study, examining data from almost 1,900 patients, half of whom were smokers. We found that smokers with MDS had a significantly higher frequency of certain gene mutations known to contribute to aggressive disease progression compared to non-smokers. This strongly suggests that smoking doesn’t just contribute to MDS development, but also accelerates its severity. [[1](https://www.cancernetwork.com/view/genetic-mutations-and-disease-progression-in-mds-increased-by-tobacco-smoking)]
**Host:** That’s truly concerning. So, what message do you have for patients with MDS who are currently smoking?
**Dr. Venugopal:** My message is clear: stopping smoking is crucial. It’s not just about your overall health, it’s about actively managing your MDS and potentially slowing its progression. Our findings show a direct link between smoking intensity and disease severity, so quitting can make a real difference in your prognosis.
**Host:** And for healthcare professionals treating MDS patients, what advice would you give them based on your research?
**Dr. Venugopal:** This research reinforces the importance of routine smoking cessation counseling for all MDS patients. We need to emphasize the detrimental impact of smoking on MDS progression and provide them with the support and resources they need to quit.
**Host:** Thank you, Dr. Venugopal, for sharing this vital information. It’s a stark reminder of the far-reaching consequences of smoking and the importance of smoke-free living.
