Clonal Hematopoiesis and Inflammation in the VasculaturE (CHIVE): a prospective, longitudinal cohort and biorepository

Blood Adv. 2024 Apr 12:bloodadvances.2023011510. doi: 10.1182/bloodadvances.2023011510. Online ahead of print.ABSTRACTClonal hematopoiesis (CH) is an age-associated phenomenon leading to increased risk of both hematologic malignancy and non-malignant organ dysfunction. Increasingly available genetic testing has made incidental discovery of CH clinically common, yet evidence-based guidelines and effective management strategies to prevent adverse CH health outcomes are lacking. To address this gap, the prospective CHIVE registry and biorepository was created to identify and monitor individuals at risk, support multidisciplinary CH clinics, and to refine standards of practice for CH risk mitigation. Data from the first 181 patients enrolled in this registry recapitulate the molecular epidemiology of CH from biobank scale retrospective studies, with DNMT3A, TET2, ASXL1, and TP53 as the most commonly mutated genes. CH patients had higher rates of end organ dysfunction, in particular chronic kidney disease (p=0.001). Among patients with CH, variant allele frequency was independently associated with presence of cytopenias (p=0.008) and progression to hematologic malignancy (p=0.010), while other common high-risk CH clone features were not clear. Notably, accumulation of multiple distinct high-risk clone features was also associated with cytopenias (p=0.013) and hematologic malignancy progression (p=0.004), supporting a recently published CH risk score. Surprisingly, ~30% of patients...

Source: Adv Data - April 12, 2024 Category: Epidemiology Authors: Morgan L Shannon Jonathan Brett Heimlich Sydney Olson Ariana Debevec Zachary Copeland Ashwin Kishtagari Caitlyn Vlasschaert Christina A Snider Alexander J Silver Donovan Brown Travis P Spaulding Manasa Ram Bhatta Kelly Pugh Shannon S Stockton Jessica Ullo Source Type: research