Colamesta Vittoria, D'Aguanno Silvia, Breccia Massimo, Bruffa Sara, Cartoni Claudio, La Torre Giuseppe
Department of Public Health and Infectious Diseases, "Sapienza"-University of Rome, Italy.
Department of Cellular Biotechnologies and Hematology, "Sapienza"-University of Rome, Italy.
Crit Rev Oncol Hematol. 2016 Mar;99:376-88. doi: 10.1016/j.critrevonc.2016.01.003. Epub 2016 Jan 15.
The aim was to perform a systematic review and meta-analysis on the relationship between tobacco smoking and the onset of acute myeloid leukemia (AML) in adults.
PubMed and Scopus databases were systematically searched. In the meta-analysis, random or fixed effects models were used according to the presence of heterogeneity. Study quality was assessed using the Newcastle-Ottawa Scale.
Twenty-seven articles were included. Case-control and cohort meta-analyses show that current, ever and former smokers have a significant increased risk to develop AML compared to never smokers [current: OR=1.36 (1.11-1.66) and RR=1.52 (1.10-2.14); ever: OR=1.25 (1.14-1.38) and RR=1.45 (1.10-1.90); former: OR=1.21 (1.03-1.41) and RR=1.45 (1.08-1.94)]. Moreover, increasing smoking intensity and duration is associated with an increase of the risk, OR shift from 1.14 (1-20 pack/years) to 2.36 (>40 pack/years).
Smoking may have a significant role in AML onset in a multistep pathogenesis.
目的是对成人吸烟与急性髓系白血病（AML）发病之间的关系进行系统评价和荟萃分析。
系统检索PubMed和Scopus数据库。在荟萃分析中，根据异质性的存在使用随机或固定效应模型。使用纽卡斯尔-渥太华量表评估研究质量。
纳入27篇文章。病例对照和队列荟萃分析表明，与从不吸烟者相比，当前吸烟者、曾经吸烟者和既往吸烟者发生AML的风险显著增加[当前：OR=1.36（1.11-1.66），RR=1.52（1.10-2.14）；曾经：OR=1.25（1.14-1.38），RR=1.45（1.10-1.90）；既往：OR=1.21（1.03-1.41），RR=1.45（1.08-1.94）]。此外，吸烟强度和持续时间的增加与风险增加相关，OR从1.14（1-20包/年）转变为2.36（>40包/年）。
吸烟可能在AML发病的多步骤发病机制中起重要作用。
