Clonal hematopoiesis and subsequent venous thromboembolism among survivors of autologous transplantation for lymphoma.

Abstract

Clonal hematopoiesis (CH) is associated with increased risk of venous thromboembolism (VTE). VTE risk is high in lymphoma and after autologous peripheral blood stem cell transplantation (aPBSCT), and CH is present in a significant number of lymphoma patients at aPBSCT. We examined if CH increases post-transplant VTE risk in lymphoma patients. The study included 557 lymphoma patients who survived ≥2 years after receiving aPBSCT between 1999 and 2014. CH was measured by targeted sequencing of cryopreserved PBSC product. Median age at aPBSCT was 54 years. Sub-distribution hazard regression analysis with death as competing risk was used to examine the association between CH in the PBSC product and post-aPBSCT VTE. CH was detected in 36.1% patients. The 8-year cumulative incidence of VTE was 8.2% with CH vs 3.6% among those without. Presence of PPM1D (HR = 4.12, 95%CI = 1.55-10.92) or TP53 mutations (HR = 5.31, 95%CI = 1.54-18.35) (ref: no CH) was associated with VTE risk in adjusted analysis.