Exploring the impact of opioid use on outcomes in allogeneic hematopoietic stem cell transplantation

• DOI: 10.1371/journal.pone.0321073
• Publication Date: 2025-04-04T17:47:44Z
• Authors: Tommy Alfaro Moya; Abel Santos Carreira; Shiyi Chen; Mats Remberger; Refik Saskin; Igor Novitzky-Basso; Jonas Mattsson

Introduction Hematological malignancies and allogeneic hematopoietic cell transplantation (alloHCT) often necessitate the use of opioids due to significant pain. This study aimed investigate impact opioid on clinical outcomes patients undergoing alloHCT. Methods A retrospective cohort was conducted by merging data from our local transplant database with anonymized pharmacy records obtained Institute for Clinical Evaluative Sciences (ICES). We analyzed 681 who underwent alloHCT at Princess Margaret Cancer Centre between January 2010 December 2019. Patients initiated within one-year post-alloHCT had prescriptions more than 30 days were categorized as intense users (IOU). Additionally, started before or less but died while also classified IOU. The analytical code used analysis is available in Supporting Information file. Results Among patients, 51 identified two-year overall survival (OS) significantly lower IOU group, 29.4% compared 53% non-IOU (HR 1.77, 95% CI 1.26–2.48, p = 0.0008). Multivariate indicated that status associated a 2.32 times higher instantaneous rate death 2.32, 1.5–3.5, 0.002). median time relapse 147 group (range 52–393) 209 day 96–1793), 0.0082. Furthermore, two years notably (31.4% vs. 16.4%, 0.0049). factors independently relapse-free (LFS) showed status, age, donor type, cytogenetic risk predictors. At years, 52.5% (p < 0.001). Conclusions In study, we found correlation worse survival, particularly concerning rates. These findings highlight need further research into pain management strategies improve reduce potential toxicity.