Therapy-Related Clonal Hematopoiesis in Patients with Non-hematologic Cancers Is Common and Associated with Adverse Clinical Outcomes Academic Article uri icon


MeSH Major

  • Antineoplastic Agents
  • DNA, Neoplasm
  • Mutation
  • Neoplasms
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins c-akt
  • Pyrimidines
  • Pyrroles


  • Clonal hematopoiesis (CH), as evidenced by recurrent somatic mutations in leukemia-associated genes, commonly occurs among aging human hematopoietic stem cells. We analyzed deep-coverage, targeted, next-generation sequencing (NGS) data of paired tumor and blood samples from 8,810 individuals to assess the frequency and clinical relevance of CH in patients with non-hematologic malignancies. We identified CH in 25% of cancer patients, with 4.5% harboring presumptive leukemia driver mutations (CH-PD). CH was associated with increased age, prior radiation therapy, and tobacco use. PPM1D and TP53 mutations were associated with prior exposure to chemotherapy. CH and CH-PD led to an increased incidence of subsequent hematologic cancers, and CH-PD was associated with shorter patient survival. These data suggest that CH occurs in an age-dependent manner and that specific perturbations can enhance fitness of clonal hematopoietic stem cells, which can impact outcome through progression to hematologic malignancies and through cell-non-autonomous effects on solid tumor biology.

publication date

  • January 2017



  • Academic Article



  • eng

PubMed Central ID

  • PMC5591073

Digital Object Identifier (DOI)

  • 10.1016/j.stem.2017.07.010

PubMed ID

  • 28803919

Additional Document Info