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COMy 2025 | The impact of CHIP on clinical outcomes in patients with myeloma treated with BCMA CAR-T
Noopur Raje, MD, Massachusetts General Hospital, Boston, MA, comments on the impact of clonal hematopoiesis of indeterminate potential (CHIP) on clinical outcomes in patients with multiple myeloma treated with BCMA CAR T-cell therapy. Dr Raje notes that CHIP is associated with prolonged neutropenia and low recovery of counts, which can be managed with supportive treatment. This interview took place at the 11th World Congress on Controversies in Multiple Myeloma (COMy) congress in Paris, France.
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Transcript
We’ve been thinking about clonal hematopoiesis for a long time. It’s been there in, as we have an aging population, you’re going to see more CHIP. And one of the things that we did do is look at the impact of CHIP on CAR T-cell outcomes. What we found was that in patients who had a high CHIP, or had CHIP-like signatures, we saw increased neutropenia, so prolonged neutropenia, increased use of growth factors, increased requirement for transfusions...
We’ve been thinking about clonal hematopoiesis for a long time. It’s been there in, as we have an aging population, you’re going to see more CHIP. And one of the things that we did do is look at the impact of CHIP on CAR T-cell outcomes. What we found was that in patients who had a high CHIP, or had CHIP-like signatures, we saw increased neutropenia, so prolonged neutropenia, increased use of growth factors, increased requirement for transfusions. We did try and look to see whether having a CHIP-like signature would predispose you to develop second cancers, specifically leukemias. Although we did find MDS leukemia in this patient population, I think the numbers didn’t suggest that there was an increased incidence of these leukemias just because you have a CHIP-like signature. So most of the impact that we saw with CHIP was more on neutropenia and low recovery of counts, which was controlled with supportive treatment, really.
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Disclosures
Consultancy: BMS, J&J, Pfizer, Sanofi, GSK, Astra Zeneca, Genentech.
