ASH 2023 | The evolution of clonal hematopoiesis and associated outcomes in multiple myeloma

Tarek H Mouhieddine, MD, Icahn School of Medicine at Mount Sinai, New York, NY, discusses a study investigating the clinical outcomes and evolution of clonal hematopoiesis in patients with newly diagnosed multiple myeloma (NDMM) who have undergone autologous stem cell transplantation (autoSCT). In a prior study during the previous treatment era for MM, the presence of clonal hematopoiesis at the time of transplant was associated with poorer overall survival (OS) and progression-free survival (PFS) in patients who were not receiving the immunomodulatory drug lenalidomide as maintenance therapy. As this is now the standard of care, the prevalence of clonal hematopoiesis in the novel treatment era is lower. However, Dr Mouhieddine highlights that this change is also likely due to the new bioinformatic algorithm used to detect clonal hematopoiesis more accurately, as this allows for improved differentiation between clonal hematopoiesis of indeterminate potential (CHIP) mutations and other mutations which may have previously affected the identification. In the recent study, the presence of CHIP was, therefore, not associated with poorer OS and PFS. However, over a three-year period, serial samples elucidated a significant increase in the prevalence of CHIP mutations over time, greater than what would be observed as a result of aging. This interview took place at the 65th ASH Annual Meeting and Exposition, held in San Diego, CA.

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