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Effects of donor-engrafted clonal hematopoiesis in allogeneic and autologous stem cell transplantation: a systematic review and meta-analysis
Authors
Xie, YiyuKazakova, Vera
Weeks, Lachelle D
Gerber, Jonathan M
Tai, Jesse
Zhang, Tian Y
Lowsky, Robert
Wu, Xiaojin
Yang, Chengwu
Patel, Shyam A
UMass Chan Affiliations
Biostatistics and Health Services ResearchMedicine
Population and Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2024-08-25
Metadata
Show full item recordAbstract
Donor stem cell health may be critically important to the success of hematopoietic stem cell transplantation (HSCT). Herein, we performed this systematic review and meta-analysis including meta-regression to assess the impact of donor-engrafted clonal hematopoiesis (CH) in allogeneic HSCT (allo-HSCT) and impact of pre-transplant CH in autologous HSCT (auto-HSCT). We applied random-effects models to analyze 5 allo-HSCT studies with 3192 donor-recipient pairs and 9 auto-HSCT studies with 2854 patients. We found that donor-engrafted CH after allo-HSCT decreased the risk of disease relapse [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI): (0.67, 0.93)], but did not affect overall survival (OS) [HR = 0.91, 95% CI: (0.75, 1.11)], progression-free survival (PFS) [HR = 0.94, 95% CI: (0.63, 1.41)], or non-relapse mortality [HR = 1.06, 95% CI: (0.81, 1.39)]. In contrast, pre-transplant CH in auto-HSCT recipients resulted in inferior OS [HR = 1.30, 95% CI: (1.16, 1.46)], inferior PFS [HR = 1.35, 95% CI: (1.18, 1.54)], and higher risk for therapy-related myeloid neoplasm [HR = 4.85, 95% CI: (2.39, 9.82)] when compared to auto-HSCT recipients without CH. This study sheds light onto the debate about prospective "CHIP screening" for stem cell donors and addresses the impact of CH as a transmissible phenomenon.Source
Xie Y, Kazakova V, Weeks LD, Gerber JM, Tai J, Zhang TY, Lowsky R, Wu X, Yang C, Patel SA. Effects of donor-engrafted clonal hematopoiesis in allogeneic and autologous stem cell transplantation: a systematic review and meta-analysis. Bone Marrow Transplant. 2024 Aug 25. doi: 10.1038/s41409-024-02403-2. Epub ahead of print. PMID: 39183321.DOI
10.1038/s41409-024-02403-2Permanent Link to this Item
http://hdl.handle.net/20.500.14038/53867PubMed ID
39183321Funding and Acknowledgements
SAP received research funding in 2022-23 from the UMass Center for Clinical and Translational Science (CCTS) Pilot Project Program grant (NIH / NCATS Grant UL1TR001453). SAP received travel support in 2024 from AAMDSIF. LDW is supported by the Edward P Evans Foundation for MDS, American Society of Hematology/Robert Wood Johnson Foundation AMFDP and Breakthrough Cancer Foundation. JT received the 2022 ASH Physician-Scientist Career Development Award. TYZ receives research funding from NIH/NCI grant 5K08CA248940-04. CY received research funding in 2022-23 from the NIH/NIDCR Grant R01DE029963 and the NIH/NIMH Grant P50MH129701. These are unrelated to the present work, and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Rights
© 2024. The Author(s), under exclusive licence to Springer Nature Limited.ae974a485f413a2113503eed53cd6c53
10.1038/s41409-024-02403-2