Clonal hematopoiesis and solid neoplasms

• Published in: Innere Medizin (Heidelberg, Germany) Vol. 63; no. 11; pp. 1133 - 1140
• Main Authors: Arends, Christopher Maximilian, Damm, Frederik
• Format: Journal Article
• Language: German
• Published: Germany 01.11.2022
• Subjects: Adenosine Diphosphate; Cell-Free Nucleic Acids; Clonal Hematopoiesis - genetics; Hematopoiesis - genetics; Humans; Leukemia, Myeloid, Acute - genetics; Poly(ADP-ribose) Polymerase Inhibitors; Ribose; Clonal hematopoiesis/risk factors; Cardiovascular diseases; Therapy-associated myeloid neoplasms; DNA repair; Precision medicine/oncology
• DOI: 10.1007/s00108-022-01404-x

Clonal hematopoiesis (CH) is a premalignant state of the hematopoietic system that frequently occurs in old age and is associated with an elevated cardiovascular risk and higher overall mortality. The prevalence and clinical implications of CH in patients with solid neoplasms were examined. A review, summary and discussion of the recent literature was carried out. CH occurs in 20-30% of patients with solid neoplasms. In the molecular diagnostics of tumor or cell-free DNA from plasma, CH mutations can be falsely interpreted as tumor mutations. CH and in particular mutations in the genes of the DNA damage repair machinery are associated with a higher risk of therapy-associated myeloid neoplasms (t-MN) following chemotherapy, radiotherapy and poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor therapy. CH is a frequent phenomenon in patients with solid neoplasms. It has high clinical relevance due to the associated risk of t‑MN. More research is needed for a better understanding of the role of CH in this patient collective and to derive evidence-based recommendations for action.