Clonal dynamics and clinical implications of postremission clonal hematopoiesis in acute myeloid leukemia

Content Provider	Scilit
Author	Tanaka, Tomoyuki Morita, Kiyomi Loghavi, Sanam Wang, Feng Furudate, Ken Sasaki, Yuya Little, Latasha D. Gumbs, Curtis E. Matthews, Jairo Daver, Naval G. Pemmaraju, Naveen DiNardo, Courtney D. Sasaki, Koji Yilmaz, Musa Kadia, Tapan Mahendra Ravandi, Farhad Konopleva, Marina Y. Kantarjian, Hagop M. Champlin, Richard E. Al-Atrash, Gheath Garcia-Manero, Guillermo Wang, Sa A. Futreal, P. Andrew Takahashi, Koichi
Copyright Year	2021
Description	Although clonal hematopoiesis (CH) can precede the development of acute myeloid leukemia (AML), it can also persist after achieving remission. Long-term clonal dynamics and clinical implications of persistent CH are not well understood. Here, we studied the prevalence, dynamics, and clinical implications of postremission CH in 164 AML patients who attained complete remission after induction chemotherapies. Postremission CH was identified in 79 (48%) patients. Postremission CH persisted long term in 91% of the trackable patients despite treatment with various types of consolidation and maintenance therapies. Postremission CH was eradicated in 20 out of 21 (95%) patients who underwent allogeneic stem cell transplant. Although patients with postremission CH as a group had comparable hematopoiesis with those without it, patients with persistent TET2 mutations showed significant neutropenia long term. Postremission CH had little impact on relapse risk, nonrelapse mortality, and incidence of atherosclerotic cardiovascular disease, although the clinical impact of post-CR CH was heterogeneous among different mutations. These data suggest that although residual clonal hematopoietic stem cells are generally resistant to consolidation and maintenance therapies, they retain the ability to maintain normal hematopoiesis and have little impact on clinical outcomes. Larger study is needed to dissect the gene-specific heterogeneity.
Related Links	https://ashpublications.org/blood/article-pdf/doi/10.1182/blood.2020010483/1808759/blood.2020010483.pdf
Ending Page	1739
Page Count	7
Starting Page	1733
DOI	10.1182/blood.2020010483
Journal	Blood
Issue Number	18
Volume Number	138
Language	English
Publisher	American Society of Hematology
Publisher Date	2021-11-04
Access Restriction	Open
Subject Keyword	Hematology Clonal Hematopoiesis Hematopoietic Treatment Postremission Ch Clinical Implications Study Journal: Blood (Vol- 129, Issue- 18)
Content Type	Text
Resource Type	Article