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Clonal hematopoiesis with DNMT3A and PPM1D mutations impairs regeneration in autologous stem cell transplant recipients.

Accepted version
Peer-reviewed

Type

Article

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Authors

Stelmach, Patrick 
Richter, Sarah 
Sauer, Sandra 
Fabre, Margarete A 
Gu, Muxin 

Abstract

Clonal hematopoiesis (CH) is an age-related condition driven by stem and progenitor cells harboring recurrent mutations linked to myeloid neoplasms. Currently, potential effects on hematopoiesis, stem cell function and regenerative potential under stress conditions are unknown. We performed targeted DNA sequencing of 457 hematopoietic stem cell grafts collected for autologous stem cell transplantation (ASCT) in myeloma patients and correlated our findings with high-dimensional longitudinal clinical and laboratory data (26,510 data points for blood cell counts/serum values in 25 days around transplantation). We detected CHrelated mutations in 152 patients (33.3%). Since many patients (n=54) harbored multiple CH mutations in one or more genes, we applied a non-negative matrix factorization (NMF) clustering algorithm to identify genes that are commonly co-mutated in an unbiased approach. Patients with CH were assigned to one of three clusters (C1-C3) and compared to patients without CH (C0) in a gene specific manner. To study the dynamics of blood cell regeneration following ASCT, we developed a time-dependent linear mixed effect model to validate differences in blood cell count trajectories amongst different clusters. The results demonstrated that C2, composed of patients with DNMT3A and PPM1D single and co-mutated CH, correlated with reduced stem cell yields and delayed platelet count recovery following ASCT. Also, the benefit of maintenance therapy was particularly strong in C2 patients. Taken together, these data indicate an impaired regenerative potential of hematopoietic stem cell grafts harboring CH with DNMT3A and PPM1D mutations.

Description

Keywords

Humans, Clonal Hematopoiesis, Hematopoietic Stem Cell Transplantation, Transplantation, Autologous, Hematopoiesis, Mutation, Regeneration, Protein Phosphatase 2C

Journal Title

Haematologica

Conference Name

Journal ISSN

0390-6078
1592-8721

Volume Title

Publisher

Ferrata Storti Foundation (Haematologica)
Sponsorship
Cancer Research UK (23015)
Medical Research Council (MC_PC_17230)