Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Blood Adv. 2022 Nov 8;6(21):5702-5706. doi: 10.1182/bloodadvances.2021006498.
Monoclonal gammopathy of undetermined significance (MGUS) and clonal hematopoiesis (CH) are 2 preclinical clonal expansions of hematopoietic cells whose prevalence rises with age, reaching almost 10% in people of aged 70 years and older. The increased risk of myeloid malignancies in patients with myeloma is well defined, and the study of the association between CH and MGUS could help explain this phenomenon. Here, we analyzed a fully clinically annotated dataset of 777 older subjects (median age, 91 years) previously screened for prevalence of CH. The prevalence of MGUS and CH was 9.6% and 17.3%, respectively. We detected CH in 9.7% of the patients with MGUS and MGUS in 5.5% of the patients with CH. We did not find a significant correlation between the presence of MGUS and CH. Furthermore, the 2 conditions showed a differential association with clinical and laboratory covariates, suggesting that MGUS and CH may represent age-associated unrelated clonal drifts of hematopoietic cells. Confirmatory studies are needed to assess the relevance of CH in plasma cell disorders. This trial was registered at www.clinicaltrials.gov as #NCT03907553.
意义未明的单克隆丙种球蛋白血症（MGUS）和克隆性造血（CH）是造血细胞的 2 种临床前克隆性扩增，其患病率随年龄增长而上升，在 70 岁以上人群中达到近 10%。骨髓瘤患者发生髓系恶性肿瘤的风险增加已得到明确界定，而研究 CH 与 MGUS 之间的关联可能有助于解释这一现象。在此，我们分析了一个之前为了筛查 CH 患病率而对 777 名老年受试者（中位年龄 91 岁）进行了充分临床注释的数据集。MGUS 和 CH 的患病率分别为 9.6%和 17.3%。我们在 9.7%的 MGUS 患者中检测到 CH，在 5.5%的 CH 患者中检测到 MGUS。我们未发现 MGUS 和 CH 之间存在显著相关性。此外，这两种情况与临床和实验室协变量呈不同关联，表明 MGUS 和 CH 可能代表与年龄相关的无关造血细胞克隆漂移。需要确证性研究来评估 CH 在浆细胞疾病中的相关性。该试验在 www.clinicaltrials.gov 上注册为 #NCT03907553。
