Clonal Hematopoiesis and Subsequent Venous Thromboembolism Among Survivors of Autologous Transplantation for Lymphoma

Authors

Radhika Gangaraju
Yanjun Chen
Lindsey Hageman
Alysia Bosworth
Elizabeth Ross
Liton Francisco
Purnima Singh
Melissa A Richard
Chengcheng Yan
Rashi Kalra
Changde Cheng
Saro H Armenian
Stephen J Forman
Ravi Bhatia
Smita Bhatia

Language

English

Publication Date

11-1-2025

Journal

JNCI: Journal of the National Cancer Institute

DOI

10.1093/jnci/djaf164

PMID

40600915

PMCID

PMC12520326

PubMedCentral® Posted Date

10-15-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Clonal hematopoiesis is associated with increased risk of venous thromboembolism (VTE). The risk of VTE is high in patients with lymphoma and after autologous peripheral blood stem cell transplantation, and clonal hematopoiesis is present in many patients with lymphoma at autologous peripheral blood stem cell transplantation. We examined whether clonal hematopoiesis increases posttransplant VTE risk in patients with lymphoma. Our study included 557 patients with lymphoma who had survived 2 or more years after receiving autologous peripheral blood stem cell transplantation between 1999 and 2014. Clonal hematopoiesis was measured by targeted sequencing of cryopreserved peripheral blood stem cell product. Median age at stem cell transplantation was 54 years. Subdistribution hazard regression analysis with death as a competing risk was used to examine the association between clonal hematopoiesis in the peripheral blood stem cell product and post-autologous peripheral blood stem cell transplantation VTE. Clonal hematopoiesis was detected in 36.1% of patients. The 8-year cumulative incidence of VTE was 8.2% with clonal hematopoiesis vs 3.6% among patients without clonal hematopoiesis. The presence of PPM1D mutation (hazard ratio = 4.12, 95% CI = 1.55 to 10.92) or TP53 mutation (hazard ratio = 5.31, 95% CI = 1.54 to 18.35), with no clonal hematopoiesis as the referent, was associated with VTE risk in adjusted analysis.

Keywords

Humans, Venous Thromboembolism, Female, Clonal Hematopoiesis, Middle Aged, Male, Transplantation, Autologous, Lymphoma, Adult, Aged, Peripheral Blood Stem Cell Transplantation, Mutation, Risk Factors, Incidence, Cancer Survivors, Tumor Suppressor Protein p53

Published Open-Access

yes

Recommended Citation

Gangaraju, Radhika; Chen, Yanjun; Hageman, Lindsey; et al., "Clonal Hematopoiesis and Subsequent Venous Thromboembolism Among Survivors of Autologous Transplantation for Lymphoma" (2025). Faculty, Staff and Students Publications. 6086.
https://digitalcommons.library.tmc.edu/baylor_docs/6086