학술논문
Clinical impact of clonal hematopoiesis in patients with lymphoma undergoing ASCT: a national population-based cohort study
Document Type
Article
Author
Husby, Simon; Favero, Francesco; Nielsen, Christian; Sørensen, Betina S.; Bæch, John; Grell, Kathrine; Hansen, Jakob W.; Rodriguez-Gonzalez, Francisco G.; Haastrup, Eva K.; Fischer-Nielsen, Anne; Andersen, Pernille; Arboe, Bente; Sækmose, Susanne G.; Hansen, Per B.; Christiansen, Ilse; Clasen-Linde, Erik; Meldgaard, Lene; Ebbesen, Lene H.; Segel, Erik K.; Josefsson, Pär; Thorsgaard, Michael; El-Galaly, Tarec C.; Brown, Peter; Weischenfeldt, Joachim; Larsen, Thomas S.; Grønbæk, Kirsten
Source
Leukemia; December 2020, Vol. 34 Issue: 12 p3256-3268, 13p
Subject
Language
ISSN
08876924; 14765551
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP) is suspected of being a risk factor for patients with cancer. This study aimed to assess the clinical consequences of CHIP in patients with lymphoma intended for high-dose chemotherapy and autologous stem-cell transplantation (ASCT) in a population-based setting. We identified 892 lymphoma patients who had undergone stem cell harvest at all transplant centers in Denmark. A total of 565 patients had an available harvest sample, which was analysed for CHIP by next-generation sequencing, and the median follow-up was 9.1 years. Of the patients who were intended for immediate ASCT, 25.5% (112/440) carried at least one CHIP mutation. In contrast to previous single-center studies CHIP was not associated with inferior overall survival (OS) in multivariate analyses. However, patients with mutations in genes of the DNA repair pathway (PPM1D, TP53, RAD21, BRCC3) had a significant inferior OS (HR after 1 year of follow-up 2.79, 95% confidence interval 1.71–4.56; p?0.0001), which also was evident in multivariate analysis (p?=?0.00067). These patients had also increased rates of therapy-related leukemia and admission to intensive care. Furthermore, in patients who did not undergo immediate ASCT, a significant inferior OS of individuals with DNA repair mutations was also identified (p?=?0.003).