Englisch Cornelia, Jäger Roland, Gassner Jasmina, Assinger Alice, Preusser Matthias, Valent Peter, Pabinger Ingrid, Ay Cihan
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Res Pract Thromb Haemost. 2025 May 8;9(4):102882. doi: 10.1016/j.rpth.2025.102882. eCollection 2025 May.
Patients with cancer are at high risk for cardiovascular events, especially venous and arterial thromboembolism (VTE/ATE). Clonal hematopoiesis (CH) has been identified as risk factor for cardiovascular diseases. However, there is limited insight into the impact of CH on thrombosis risk in patients with cancer.
The aim of this study was to elucidate the association between CH and cancer-associated VTE and ATE within the framework of the Vienna Cancer and Thrombosis Study (CATS), a prospective observational cohort study.
Peripheral blood DNA samples collected at study inclusion were screened for CH-associated mutations.
In this study, 967 patients (median age: 61 [interquartile range, IQR: 50-68] years, 49.9% female) were included and followed-up for a median of 24 (IQR: 24-24) months. Of those, 787 (78.3%) had newly diagnosed cancer and 434 (44.9%) had stage IV disease. We identified 52 CH-associated variants in 46 patients (4.8%). Mutations in the genes (48.1%) and (17.3%) were most commonly found. The presence of CH was not associated with VTE (adjusted subdistribution hazard ratio: 0.68, 95% CI: 0.21-2.19) or ATE risk (adjusted subdistribution hazard ratio: 1.08, 95% CI: 0.15-8.06). Available laboratory parameters and inflammatory and hemostatic biomarkers did not differ according to CH carrier status. Compared with patients without CH, those with CH showed decreased overall survival; however, this was not independent of age.
In our cohort of patients with cancer, the presence of CH was not associated with an increased risk of VTE or ATE. CH had no independent impact on overall survival.
癌症患者发生心血管事件的风险很高，尤其是静脉和动脉血栓栓塞（VTE/ATE）。克隆性造血（CH）已被确定为心血管疾病的危险因素。然而，关于CH对癌症患者血栓形成风险的影响，目前了解有限。
本研究旨在在前瞻性观察队列研究维也纳癌症与血栓形成研究（CATS）的框架内，阐明CH与癌症相关的VTE和ATE之间的关联。
对研究纳入时采集的外周血DNA样本进行CH相关突变筛查。
本研究纳入了967例患者（中位年龄：61岁[四分位间距，IQR：50 - 68岁]，49.9%为女性），中位随访时间为24个月（IQR：24 - 24个月）。其中，787例（78.3%）为新诊断癌症患者，434例（44.9%）为IV期疾病患者。我们在46例患者（4.8%）中鉴定出52个CH相关变异。基因中的突变（48.1%）和（17.3%）最为常见。CH的存在与VTE（校正后亚分布风险比：0.68，95%置信区间：0.21 - 2.19）或ATE风险（校正后亚分布风险比：1.08，95%置信区间：0.15 - 8.06）无关。可用的实验室参数以及炎症和止血生物标志物根据CH携带者状态并无差异。与无CH的患者相比，有CH的患者总生存期降低；然而，这并非独立于年龄因素。
在我们的癌症患者队列中，CH的存在与VTE或ATE风险增加无关。CH对总生存期无独立影响。
