Predicting therapy‐related myeloid neoplasms after CAR‐T with the Clonal Haematopoiesis Risk Score (CHRS)
The clonal haematopoiesis risk score (CHRS) was proposed to predict the rate of progression from clonal haemopoiesis of indeterminate potential (CHIP)/clonal cytopenia with unknown significance (CCUS) to myeloid neoplasms in the general population. CHRS encompasses the type and VAF of the mutation,...
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| Veröffentlicht in: | British journal of haematology 2025-01, Vol.206 (1), p.372-374 |
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| creator | Galli, Eugenio Rossi, Monica Pansini, Ilaria Viscovo, Marcello Malara, Tanja Colangelo, Maria Alma, Eleonora Valentini, Caterina Giovanna Teofili, Luciana Hohaus, Stefan Sica, Simona Sorà, Federica Chiusolo, Patrizia |
| description | The clonal haematopoiesis risk score (CHRS) was proposed to predict the rate of progression from clonal haemopoiesis of indeterminate potential (CHIP)/clonal cytopenia with unknown significance (CCUS) to myeloid neoplasms in the general population. CHRS encompasses the type and VAF of the mutation, the presence of a single DNMT3A mutation, cytopenia, age, red cell distribution width (RDW) and mean corpuscular volume (MCV). We studied clonal haematopoiesis in a cohort of 55 consecutive patients treated with CD19‐directed CAR‐T cells: CHIP and CCUS were present in 7% and 33% of patients before CAR‐T. Three therapy‐related myeloid neoplasms (t‐MN) were observed after treatment with CAR‐T (2 MDS and 1 AML). Only patients with an intermediate‐high baseline CHRS developed a t‐MN. Patients with an intermediate‐high CHRS had more than a twofold increased risk of developing a t‐MN within the first 9 months after CAR‐T (odds ratio 2.89, 95% C.I. 1.98–4.19, p |
| doi_str_mv | 10.1111/bjh.19905 |
| format | Article |
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CHRS encompasses the type and VAF of the mutation, the presence of a single DNMT3A mutation, cytopenia, age, red cell distribution width (RDW) and mean corpuscular volume (MCV). We studied clonal haematopoiesis in a cohort of 55 consecutive patients treated with CD19‐directed CAR‐T cells: CHIP and CCUS were present in 7% and 33% of patients before CAR‐T. Three therapy‐related myeloid neoplasms (t‐MN) were observed after treatment with CAR‐T (2 MDS and 1 AML). Only patients with an intermediate‐high baseline CHRS developed a t‐MN. Patients with an intermediate‐high CHRS had more than a twofold increased risk of developing a t‐MN within the first 9 months after CAR‐T (odds ratio 2.89, 95% C.I. 1.98–4.19, p < 0.001). Overall, CHRS was able to predict the occurrence of t‐MN after CAR‐T with good specificity.</description><identifier>ISSN: 0007-1048</identifier><identifier>ISSN: 1365-2141</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1111/bjh.19905</identifier><identifier>PMID: 39539012</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Age composition ; Aged ; CD19 antigen ; Clonal Hematopoiesis ; Cytopenia ; DNA Methyltransferase 3A ; Female ; Hemopoiesis ; Humans ; Immunotherapy, Adoptive - adverse effects ; Lymphocytes T ; Male ; Middle Aged ; Mutation ; Myelodysplastic Syndromes - etiology ; Myelodysplastic Syndromes - therapy ; Neoplasms, Second Primary - etiology ; Risk Assessment ; Risk Factors ; Tumors ; Young Adult</subject><ispartof>British journal of haematology, 2025-01, Vol.206 (1), p.372-374</ispartof><rights>2024 British Society for Haematology and John Wiley & Sons Ltd.</rights><rights>2025 British Society for Haematology and John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2435-95f1044aa76d6ae72b8ef5df5de2f684e227ee5ecbc903e9173d6e9babfccad23</cites><orcidid>0000-0002-2839-916X ; 0000-0002-9607-5298 ; 0000-0002-1355-1587 ; 0000-0002-7022-5366 ; 0000-0002-7214-1561 ; 0000-0003-2426-3465</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjh.19905$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjh.19905$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39539012$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Galli, Eugenio</creatorcontrib><creatorcontrib>Rossi, Monica</creatorcontrib><creatorcontrib>Pansini, Ilaria</creatorcontrib><creatorcontrib>Viscovo, Marcello</creatorcontrib><creatorcontrib>Malara, Tanja</creatorcontrib><creatorcontrib>Colangelo, Maria</creatorcontrib><creatorcontrib>Alma, Eleonora</creatorcontrib><creatorcontrib>Valentini, Caterina Giovanna</creatorcontrib><creatorcontrib>Teofili, Luciana</creatorcontrib><creatorcontrib>Hohaus, Stefan</creatorcontrib><creatorcontrib>Sica, Simona</creatorcontrib><creatorcontrib>Sorà, Federica</creatorcontrib><creatorcontrib>Chiusolo, Patrizia</creatorcontrib><title>Predicting therapy‐related myeloid neoplasms after CAR‐T with the Clonal Haematopoiesis Risk Score (CHRS)</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>The clonal haematopoiesis risk score (CHRS) was proposed to predict the rate of progression from clonal haemopoiesis of indeterminate potential (CHIP)/clonal cytopenia with unknown significance (CCUS) to myeloid neoplasms in the general population. CHRS encompasses the type and VAF of the mutation, the presence of a single DNMT3A mutation, cytopenia, age, red cell distribution width (RDW) and mean corpuscular volume (MCV). We studied clonal haematopoiesis in a cohort of 55 consecutive patients treated with CD19‐directed CAR‐T cells: CHIP and CCUS were present in 7% and 33% of patients before CAR‐T. Three therapy‐related myeloid neoplasms (t‐MN) were observed after treatment with CAR‐T (2 MDS and 1 AML). Only patients with an intermediate‐high baseline CHRS developed a t‐MN. Patients with an intermediate‐high CHRS had more than a twofold increased risk of developing a t‐MN within the first 9 months after CAR‐T (odds ratio 2.89, 95% C.I. 1.98–4.19, p < 0.001). 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Rossi, Monica ; Pansini, Ilaria ; Viscovo, Marcello ; Malara, Tanja ; Colangelo, Maria ; Alma, Eleonora ; Valentini, Caterina Giovanna ; Teofili, Luciana ; Hohaus, Stefan ; Sica, Simona ; Sorà, Federica ; Chiusolo, Patrizia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2435-95f1044aa76d6ae72b8ef5df5de2f684e227ee5ecbc903e9173d6e9babfccad23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Age composition</topic><topic>Aged</topic><topic>CD19 antigen</topic><topic>Clonal Hematopoiesis</topic><topic>Cytopenia</topic><topic>DNA Methyltransferase 3A</topic><topic>Female</topic><topic>Hemopoiesis</topic><topic>Humans</topic><topic>Immunotherapy, Adoptive - adverse effects</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Myelodysplastic Syndromes - etiology</topic><topic>Myelodysplastic Syndromes - therapy</topic><topic>Neoplasms, Second Primary - etiology</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Galli, Eugenio</creatorcontrib><creatorcontrib>Rossi, Monica</creatorcontrib><creatorcontrib>Pansini, Ilaria</creatorcontrib><creatorcontrib>Viscovo, Marcello</creatorcontrib><creatorcontrib>Malara, Tanja</creatorcontrib><creatorcontrib>Colangelo, Maria</creatorcontrib><creatorcontrib>Alma, Eleonora</creatorcontrib><creatorcontrib>Valentini, Caterina Giovanna</creatorcontrib><creatorcontrib>Teofili, Luciana</creatorcontrib><creatorcontrib>Hohaus, Stefan</creatorcontrib><creatorcontrib>Sica, Simona</creatorcontrib><creatorcontrib>Sorà, Federica</creatorcontrib><creatorcontrib>Chiusolo, Patrizia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Galli, Eugenio</au><au>Rossi, Monica</au><au>Pansini, Ilaria</au><au>Viscovo, Marcello</au><au>Malara, Tanja</au><au>Colangelo, Maria</au><au>Alma, Eleonora</au><au>Valentini, Caterina Giovanna</au><au>Teofili, Luciana</au><au>Hohaus, Stefan</au><au>Sica, Simona</au><au>Sorà, Federica</au><au>Chiusolo, Patrizia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting therapy‐related myeloid neoplasms after CAR‐T with the Clonal Haematopoiesis Risk Score (CHRS)</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2025-01</date><risdate>2025</risdate><volume>206</volume><issue>1</issue><spage>372</spage><epage>374</epage><pages>372-374</pages><issn>0007-1048</issn><issn>1365-2141</issn><eissn>1365-2141</eissn><abstract>The clonal haematopoiesis risk score (CHRS) was proposed to predict the rate of progression from clonal haemopoiesis of indeterminate potential (CHIP)/clonal cytopenia with unknown significance (CCUS) to myeloid neoplasms in the general population. CHRS encompasses the type and VAF of the mutation, the presence of a single DNMT3A mutation, cytopenia, age, red cell distribution width (RDW) and mean corpuscular volume (MCV). We studied clonal haematopoiesis in a cohort of 55 consecutive patients treated with CD19‐directed CAR‐T cells: CHIP and CCUS were present in 7% and 33% of patients before CAR‐T. Three therapy‐related myeloid neoplasms (t‐MN) were observed after treatment with CAR‐T (2 MDS and 1 AML). Only patients with an intermediate‐high baseline CHRS developed a t‐MN. Patients with an intermediate‐high CHRS had more than a twofold increased risk of developing a t‐MN within the first 9 months after CAR‐T (odds ratio 2.89, 95% C.I. 1.98–4.19, p < 0.001). Overall, CHRS was able to predict the occurrence of t‐MN after CAR‐T with good specificity.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>39539012</pmid><doi>10.1111/bjh.19905</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0002-2839-916X</orcidid><orcidid>https://orcid.org/0000-0002-9607-5298</orcidid><orcidid>https://orcid.org/0000-0002-1355-1587</orcidid><orcidid>https://orcid.org/0000-0002-7022-5366</orcidid><orcidid>https://orcid.org/0000-0002-7214-1561</orcidid><orcidid>https://orcid.org/0000-0003-2426-3465</orcidid></addata></record> |
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| subjects | Adult Age composition Aged CD19 antigen Clonal Hematopoiesis Cytopenia DNA Methyltransferase 3A Female Hemopoiesis Humans Immunotherapy, Adoptive - adverse effects Lymphocytes T Male Middle Aged Mutation Myelodysplastic Syndromes - etiology Myelodysplastic Syndromes - therapy Neoplasms, Second Primary - etiology Risk Assessment Risk Factors Tumors Young Adult |
| title | Predicting therapy‐related myeloid neoplasms after CAR‐T with the Clonal Haematopoiesis Risk Score (CHRS) |
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