17 DHC 2025
22 - 24 January 2025
Myeloid abstracts (4)
Abstract
Longitudinal dynamics of mutant TET2 clonal hematopoiesis
23 January
15:15 15:30
Maaike van Bergen
Paper

Longitudinal dynamics of mutant TET2 clonal hematopoiesis

Maaike van Bergen (1), Aniek de Graaf (1), Isabelle van Zeventer (2), Bert van der Reijden (1), Jan Jacob Schuringa (2), Siddhartha Kar (3), Gerwin Huls (2), Joop Jansen (1)
(1) Radboudumc, Laboratory Medicine, Laboratory of Hematology, Nijmegen, (2) University Medical Center Groningen, Department of Hematology, Groningen, (3) University of Cambridge, Department of Oncology, Cambridge
No potential conflicts of interest
Introduction

Clonal hematopoiesis (CH) is defined by acquired mutations in leukemia driver genes within the hematopoietic stem- and progenitor cells, which provides these cells with a growth advantage over the wild type cells, resulting in clonal expansion. CH is detected in the peripheral blood of >30% of older individuals (above 60 years) and the prevalence increases up to 50% in elderly above 80 years old. The presence of CH associates with an increased morbidity and all-cause mortality and a tenfold increased risk of developing leukemia. Mutations in DNMT3A and TET2, both involved in the DNA methylation pathway, are identified in approximately 80% of the individuals with CH mutations. While DNMT3A functions as a methyltransferase, TET2 plays a role in the active hydroxylation and demethylation of 5-methylcytosines. Studies have shown that mutant TET2 cells may contribute to localized hyperinflammation, increasing the risk of developing cardiovascular disease. We have previously shown that individuals who carry mutations in TET2 are significantly more likely to acquire additional mutations in either TET2 or SRSF2, and the presence of TET2 mutations significantly elevates the risk of developing hematological malignancies. Here, we aim to further characterize individuals with CH and TET2 mutations, their co-mutations, expansion rate and the risk of adverse events.

Methods

We study clonal hematopoiesis in the Dutch population-based Lifelines cohort (n=167,729). We performed error-corrected, next-generation sequencing of 27 genes recurrently mutated in myeloid malignancies in n=5548 individuals at baseline, n=4377 individuals after follow-up visit 1 and n=782 individuals after follow-up visit 2 with a variant allele frequency (VAF) cut-off >1%.

Results

In total, 649/5548 individuals with TET2 mutations were identified at baseline, 558/4377 individuals with TET2 mutations during the first follow-up visit and 92/782 individuals with TET2 mutations at the second follow-up visit. Individuals could be categorized according to their expansion pattern over time (e.g. expanding, declining or stable at follow-up). We analyzed the distinctions between these three subgroups by assessing the type of mutations, (number of) co-mutations, germline variation and methylation status.

Conclusion

While TET2 mutations occur frequently within the general population, distinct subgroups can be identified that may affect their risk of adverse events.

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