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ASH 2025 | Advice for applying the Clonal Hematopoiesis Risk Score in clinical practice
In this video, Lachelle Weeks, MD, PhD, Dana-Farber Cancer Institute, Boston, MA, discusses the Clonal Hematopoiesis Risk Score (CHRS) and its application in clinical practice, noting that while the score provides a population-level estimate of risk of progression to certain myeloid malignancies, there is a need for practicing hematologists to consider additional clinical context on a patient-by-patient basis. Dr Weeks highlights that certain clinical features, including sickle cell disease (SCD), chemotherapy, or radiation therapy, can accelerate risk beyond what is estimated by the CHRS. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
The clonal hematopoiesis risk score was developed or derived rather in a population-based setting. So it is a tool that is really good at estimating population-level risk. And it can tell you in a population of people with clonal hematopoiesis, either CHIP or CCUS designated, what their five- and 10-year estimated risk of developing MDS, AML, or MPNs actually is. One of the things that it’s not good at is estimating risk in certain select clinical contexts...
The clonal hematopoiesis risk score was developed or derived rather in a population-based setting. So it is a tool that is really good at estimating population-level risk. And it can tell you in a population of people with clonal hematopoiesis, either CHIP or CCUS designated, what their five- and 10-year estimated risk of developing MDS, AML, or MPNs actually is. One of the things that it’s not good at is estimating risk in certain select clinical contexts. And so for the practical hematologist, you can kind of get a sense of, based on the molecular details of a patient, as well as their blood counts and their age, you can get a sense of whether or not in the population they would be considered low, intermediate, or high risk for progressing to a blood cancer. But then when you layer on top of that clinical context, like sickle cell disease or like cancer chemotherapy or radiation therapy, you actually accelerate that risk even further, and that’s not accounted for in the CHRS. And so what I would tell to the hematologist using our score is that it’s effective as a sort of population-level estimate, but it’s also important to sort of think about the clinical context in which you’re seeing the patient and understand that there are other clinical features such as the exposures that a person is experiencing that can sort of accelerate the risk beyond what can be estimated by the CHRS.
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