Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic Stem Cell Transplantation in AML Patients

Xiaoxuan Wei; Sai Huang; Zhenyang Gu; Jing Liu; Meng Li; Xiangshu Jin; Jian Bo; Fei Li; Yu Jing; Xiaoning Gao; Liping Dou; Daihong Liu; Chunji Gao

doi:10.12659/AOT.943688

02 July 2024 : Original article

Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic Stem Cell Transplantation in AML Patients

Xiaoxuan Wei^12ABCDEF, Sai Huang^1ABF, Zhenyang Gu^1ADEF, Jing Liu^1ADEF, Meng Li^1AF, Xiangshu Jin^1AF, Jian Bo^1AF, Fei Li^1A, Yu Jing^1A, Xiaoning Gao^1A, Liping Dou^1AB, Daihong Liu^1A, Chunji Gao^1ADEF*

DOI: 10.12659/AOT.943688

Ann Transplant 2024; 29:e943688

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Table 1 Characteristics of patients.

Characteristic	TotalN=196	No CH mutationN=103	With CH mutationsN=93	P value
Age	38 (11–64)	36 (13–62)	42 (11–64)	0.003^a
Sex
Female	73 [37.2]	33 [32.0]	40 [43.0]	0.113
Male	123 [62.8]	70 [68.0]	53 [57.0]	0.113
AML type
De Novo	182 [92.6]	93 [90.3]	89 [95.7]	0.142
Secondary	14 [7.4]	10 [9.7]	4 [4.3]	0.142
WBC, ×10/L	31.1 (3.8–40.7)	36.3 (4.7–49.9)	25.3 (3.0–31.2)	0.094^b
Platelet, ×10/L	79.1 (26.0–103.0)	79.9 (25.0–90.0)	84.8 (27.3–105.0)	0.048^b
Hemoglobin, g/dL	89.4 (70.0–110.0)	89.5 (70.0–110.0)	89.3 (70.3–111.0)	0.923^b
Bone marrow blasts, %	57.9 (38.5–80.0)	58.8 (40.0–80.6)	56.9 (38.1–77.2)	0.556^b
Complex karyotypes
Absent	184 [93.9]	98 [95.2]	86 [92.5]	0.436
Present	12 [6.1]	5 [4.8]	7 [7.5]
NCCN risk stratification^#
Favorable-risk	80 [40.8]	43 [41.7]	37 [39.8]	0.584
Intermediate-risk	49 [25.0]	28 [27.2]	21 [22.6]
Poor-risk	67 [34.2]	32 [31.1]	35 [37.6]
Disease status at transplantation
De Novo	1 [0.5]	1 [1.0]	0 [0]	0.305^*
CR	174 [88.8]	91 [88.3]	83 [89.3]
PR	6 [3.1]	3 [2.9]	3 [3.2]
NR	6 [3.1]	2 [1.9]	4 [4.3]
Relapse	9 [4.5]	6 [5.9]	3 [3.2]
Donor type
Sibling matched	62 [31.6]	37 [36.0]	25 [26.9]	0.397
Unrelated matched	10 [5.1]	5 [4.8]	5 [5.4]
Haploidentical	124 [63.3]	61 [59.2]	63 [67.7]
NOTE. Data are no. [%] unless otherwise specified. P values are from two-sided tests for categoric variables. ^a represents the result from unpaired t test. ^b represents the results from Mann-Whitney tests. ^* represents the results from Fisher’s exact tests. ^# NCCN risk stratification is based on NCCN guidelines in 2021. CH mutation – clonal hematopoiesis-associated mutation; AML – acute myeloid leukemia; WBC – white blood cell count; NCCN – National Comprehensive Cancer Network; CR – complete remission; PR – partial response; NR – no response.

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Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic Stem Cell Transplantation in AML Patients

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