IMS 2023 | CHIP in patients with AL amyloidosis: clinical implications
Paolo Lopedote, MD, St Elizabeth’s Medical Center, Boston, MA, discusses the presence of clonal hematopoiesis of indeterminate potential (CHIP) in patients with hematological malignancies, in particular, light chain (AL) amyloidosis. Dr Lopedote reports on recent research which investigated the prevalence of CHIP in patients with amyloidosis, and identified an association between presence of CHIP and translocations. This interview took place at the 20th International Myeloma Society (IMS) Annual Meeting, held in Athens, Greece.
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Transcript (edited for clarity)
CHIP is an entity that is being more and more recognized recently. It has been initially associated with worse outcome, cardiovascular outcome, in the general population. More recently there has been growing interest to see the impact of the presence of CHIP in patients with hematological malignancies. In the context of myeloma, we already know that there seems to be some worse outcomes for patients undergoing transplantation and harboring CHIP...
CHIP is an entity that is being more and more recognized recently. It has been initially associated with worse outcome, cardiovascular outcome, in the general population. More recently there has been growing interest to see the impact of the presence of CHIP in patients with hematological malignancies. In the context of myeloma, we already know that there seems to be some worse outcomes for patients undergoing transplantation and harboring CHIP. Similarly, there has been some data for patients with lymphoma, but in the context of amyloidosis, it’s much less clear the role of CHIP presence. Also, it’s not entirely clear the frequency of CHIP presence. So far, some studies have tried to assess the presence of CHIP in patients with amyloidosis. No clear impact in terms of prognosis has been identified, but these studies were small and with short follow-up. We tried also to look at the presence of CHIP in a cohort of amyloidosis patients and we were able to do this together with the mentorship of Dr Giada Bianchi from Dana-Farber, and through a collaboration with from the University of Milan. So again, we looked at a cohort of amyloidosis patients, probably the largest cohort so far, meaning that we were able to look at a total of 70 patients, and approximately 20% were found to have CHIP. We found some association between the presence of CHIP and the presence of translocation, which is usually associated with a lower outcome in amyloidosis patients. Together with that we also found an interesting association with a lower…renal stage in patients with amyloidosis. These are preliminary data – we are still trying to explore the significance of these findings. We are also trying to explore any impact of CHIP in patients with amyloidosis in terms of prognosis. We were unable to find any meaningful impact on prognosis so far, but again follow-up time is still short and unfortunately the cohort is still small. We are hopeful to gather more data in the future and further clarify the impact of CHIP in this cohort of patients.
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