Influence of cannabis use on relapse and remission rates in patients with acute lymphoblastic leukemia (ALL).

e18526 Background: There is a paucity of data regarding the impact of cannabis on relapse and remission rates, as well as other clinical outcomes, in patients who received chemotherapy for acute lymphoblastic leukemia (ALL) based on real world data. This retrospective observational study aims to identify the potential effect of cannabis use on treatment, mood, and other clinical outcomes in patients with ALL who received chemotherapy. Methods: We queried the TriNetX Global collaborative network from January 2006 to December 2021 for patients aged 18 years or older diagnosed with ALL. Patients were stratified based on cannabis use. Propensity scores matching done for sociodemographics, other malignancies, lab values, and chemotherapeutic medications resulted in 287 patients in each cohort. The primary outcome was achieving remission from acute leukemia. Secondary outcomes were acute leukemia relapse, all-cause mortality, ICU admission, sepsis, acute kidney injury (AKI), chronic pain, anxiety disorders, and depression. Odds ratios obtained via conditional logistic regression were used to compare outcomes over a 4-year follow-up period. Results: Age at index event was 35.2 years in the cannabis cohort and 37.2 years in the control arm. The cannabis cohort was associated with a significantly lower odds of the primary outcome (OR 0.56; 95% CI: 0.35-0.91, p=0.018). Cannabis use was also associated with higher odds of some secondary outcomes, including acute leukemia relapse (OR 1.91; 1.05-3.47, p=0.031), chronic pain (OR 1.70; 1.03-2.80, p=0.035), and anxiety disorders (OR 2.59; 1.54-4.34, p<0.0001). No significant difference was seen between cannabis users and the control cohort for all-cause mortality (OR 1.18; 95% CI: 0.80-1.73, p=0.414), ICU admission (OR 1.13; 0.69-1.86, p=0.632), respiratory failure (OR 1.02; 95% CI: 0.60-1.74, p=0.945), sepsis (OR 1.10; 95% CI: 0.72-1.71, p=0.650) and AKI (OR 0.97; 95% CI: 0.58-1.62, p=0.899) and depression (OR 1.64; 95% CI: 0.98-2.75, p=0.059). Conclusions: Among patients with ALL who received chemotherapy, cannabis use was associated with a significantly lower odds of remission, higher odds of relapse, chronic pain, and anxiety disorders, but no association with all-cause mortality, depression, or respiratory failure.