Association of smoking with disease progression in persons with multiple sclerosis undergoing autologous hematopoietic cell transplantation: a single-center experience

Danitza Fernandez-Lara, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico
José M. Porcel, Pleural Medicine Unit, Department of Internal Medicine, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
Robinson Robles-Hernández, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
Olivia Lira-Lara, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico; Universidad Veracruzana, Veracruz, Mexico
Miranda Melgar-de-la-Paz, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico; Universidad Anáhuac Puebla, Puebla, Mexico
Moisés M. Gallardo-Pérez, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico
Juan C. Olivares-Gazca, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico
Guillermo J. Ruiz-Delgado, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico; Universidad Anáhuac Puebla, Puebla, Mexico
Guillermo J. Ruiz-Argüelles, Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico; Universidad Anáhuac Puebla, Puebla, Mexico

Background: Smoking remains a significant issue that increases the prevalence of multiple sclerosis (MS) and its progression to secondary progressive forms. Objectives: The goal is to identify the relationship between smoking and disease progression in MS patients who have undergone autologous hematopoietic stem cell transplantation (auto-HSCT) at the Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico. Methods: This retrospective study involved MS patients treated with auto-HSCT, followed for 12 months. The response to transplantation was measured using the difference in Expanded Disability Status Scale (EDSS) scores before and 12 months after the transplant. A difference of −0.5 or greater indicated a good response, while a difference below 0.5 indicated a poor response. Results: The study included 419 patients, with a median age of 47 years (IQR: 40-53). The majority were non-smokers (315) compared to smokers/ex-smokers (104). In patients with PMSS, EDSS stabilization at 12 months was observed in both smokers/ex-smokers (median 6, interquartile range (IQR) = 1 vs. 6, IQR = 1, p = 0.466) and non-smokers (median 6, IQR = 1 vs. 6, IQR = 1.5, p = 0.001), although non-smokers showed a statistically significant difference. Conclusion: Smoking may negatively impact MS progression, especially in its progressive forms.

Keywords: Multiple sclerosis. Smoking. Auto-HSCT. Disease progression.