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      Role of Donor Clonal Hematopoiesis in Allogeneic Hematopoietic Stem-Cell Transplantation

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      Journal of Clinical Oncology
      American Society of Clinical Oncology (ASCO)

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          Abstract

          Clonal hematopoiesis of indeterminate potential (CHIP) occurs in the blood of approximately 20% of older persons. CHIP is linked to an increased risk of hematologic malignancies and of all-cause mortality; thus, the eligibility of stem-cell donors with CHIP is questionable. We comprehensively investigated how donor CHIP affects outcome of allogeneic hematopoietic stem-cell transplantation (HSCT).

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          Most cited references28

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          Pathophysiology of Chronic Graft-versus-Host Disease and Therapeutic Targets

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            Is Open Access

            Leukemia-Associated Somatic Mutations Drive Distinct Patterns of Age-Related Clonal Hemopoiesis

            Summary Clonal hemopoiesis driven by leukemia-associated gene mutations can occur without evidence of a blood disorder. To investigate this phenomenon, we interrogated 15 mutation hot spots in blood DNA from 4,219 individuals using ultra-deep sequencing. Using only the hot spots studied, we identified clonal hemopoiesis in 0.8% of individuals under 60, rising to 19.5% of those ≥90 years, thus predicting that clonal hemopoiesis is much more prevalent than previously realized. DNMT3A-R882 mutations were most common and, although their prevalence increased with age, were found in individuals as young as 25 years. By contrast, mutations affecting spliceosome genes SF3B1 and SRSF2, closely associated with the myelodysplastic syndromes, were identified only in those aged >70 years, with several individuals harboring more than one such mutation. This indicates that spliceosome gene mutations drive clonal expansion under selection pressures particular to the aging hemopoietic system and explains the high incidence of clonal disorders associated with these mutations in advanced old age.
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              Somatic Mutations and Clonal Hematopoiesis in Aplastic Anemia.

              In patients with acquired aplastic anemia, destruction of hematopoietic cells by the immune system leads to pancytopenia. Patients have a response to immunosuppressive therapy, but myelodysplastic syndromes and acute myeloid leukemia develop in about 15% of the patients, usually many months to years after the diagnosis of aplastic anemia.
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                Author and article information

                Journal
                Journal of Clinical Oncology
                JCO
                American Society of Clinical Oncology (ASCO)
                0732-183X
                1527-7755
                November 07 2018
                November 07 2018
                : JCO.2018.79.218
                Affiliations
                [1 ]Mareike Frick, Willy Chan, Christopher Maximilian Arends, Raphael Hablesreiter, Adriane Halik, Olga Blau, Kaja Hoyer, Friederike Christen, Joel Galan-Sousa, Daniel Noerenberg, Igor Wolfgang Blau, Armin Gerbitz, Lars Bullinger, and Frederik Damm, Charité - University Medical Center Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Tomasz Zemojtel, Berlin Institute of Health (BIH) Core Genomics Facility, Charité, University Medical Center,...
                Article
                10.1200/JCO.2018.79.2184
                30403573
                e6456e29-0aa4-4ec0-8ad3-008d1c928be8
                © 2018
                History

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