Dr Sun on the Relationship Between Clonal Hematopoiesis and Cardiovascular Disease in RCC

Maxine Sun, PhD, MPH, research scientist, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, research consultant, Brigham and Women's Hospital, discusses the association between clonal hematopoiesis and cardiovascular disease in patients with renal cell carcinoma (RCC).

Clonal hematopoiesis occurs when a mutation in the hematopoietic system provides a cell with a survival advantage over normal cells, allowing for its clonal expansion, Sun begins. This phenomenon is commonly driven by somatic mutations in known oncogenes and tumor suppressor genes or by somatic mosaic chromosomal alterations.

Prior research has established that clonal hematopoiesis is associated with a high risk of developing hematologic malignancies, Sun continues. However, an increasing body of evidence in the past few years indicates that clonal hematopoiesis is causally linked with cardiovascular disease when driven by certain mutations, Sun adds. Accordingly, it is considered a new cardiovascular risk factor.

A prospective cohort analysis of patients with a cancer diagnosis in the UK Biobank was conducted to identify the effect of somatic mosaic chromosomal alterations on cardiovascular disease, Sun details. These alterations were characterized using DNA genotyping array intensity data and long-range chromosomal phase inference. The risk of death caused by cardiovascular disease, death by coronary artery disease, death of cancer causes, and death of any cause were all evaluated. Exploratory end points included the risk of various incident cardiovascular phenotypes.

The study revealed that patients with clonal hematopoiesis were at a higher risk of death from cardiovascular disease and coronary artery disease, Sun reports. Sub-analyses revealed that this risk was higher in patients with somatic mosaic chromosomal alterations who had RCC, Sun concludes. This indicates that clonal hematopoiesis may be a relevant potential risk factor in this disease.