{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:14:47Z","timestamp":1790154887244,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Age\u2010related changes in human hematopoietic stem cells (HSCs) often form the basis for clonal hematopoiesis (CH), which presages the development of overt myeloid neoplasm with variable risk. CH can also arise after exposure to chemotherapy, radiotherapy, or immune interventions. In this study, we performed clinico\u2010genomic profiling of therapy\u2010related CH (t\u2010CH) (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200967) versus\n                    <jats:italic>de novo<\/jats:italic>\n                    CH (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009123) from a multidisciplinary CHIP Clinic. The most enriched mutations in t\u2010CH were\n                    <jats:italic>TET2<\/jats:italic>\n                    (26.2%),\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    (22.4%), and\n                    <jats:italic>TP53<\/jats:italic>\n                    (8.4%). Median latency period from the time of initial exposure to the diagnosis of t\u2010CH was 6.96\u2009\u00b1\u20091.10\u2009years. Patients with t\u2010CH had inferior event\u2010free survival compared to\n                    <jats:italic>de novo<\/jats:italic>\n                    CH (median 29.9\u2009months\u00a0versus 122.1\u2009months,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0045). Overall survival was also shorter in t\u2010CH versus\n                    <jats:italic>de novo<\/jats:italic>\n                    CH (median 55.3\u2009months vs. 129.2\u2009months,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.043). Genes that imparted significantly increased risk for progression from t\u2010CH to overt therapy\u2010related myeloid neoplasm (t\u2010MN) included\n                    <jats:italic>JAK2<\/jats:italic>\n                    (relative risk (RR) 9.42,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0001),\n                    <jats:italic>RUNX1<\/jats:italic>\n                    (RR 7.11,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001),\n                    <jats:italic>EZH2<\/jats:italic>\n                    (RR 7.11,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), and\n                    <jats:italic>TET2<\/jats:italic>\n                    (RR 13.4,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). Clonal dynamic modeling of patients with t\u2010CH who progressed to\u00a0overt t\u2010MN showed an increase in the relative clonal fraction and new clonal outgrowth. In the t\u2010CH cohort, higher mean variant allele frequency was observed in progressors versus non\u2010progressors (77.1% vs. 30.6%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.017). This study sheds light onto outcomes for CH based on differing clinical ontogeny and has implications for previvorship for secondary malignancies.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70374","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:20:24Z","timestamp":1779250824000},"page":"1915-1927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ontogeny and Natural History of Therapy\u2010Related Clonal Hematopoiesis From a Multidisciplinary\n                    <scp>CHIP<\/scp>\n                    Clinic"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8208-1902","authenticated-orcid":false,"given":"Shyam A.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology\/Oncology, UMass Memorial Medical Center UMass Chan Medical School  Worcester Massachusetts 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakiko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology\/Oncology, UMass Memorial Medical Center UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology\/Oncology, UMass Memorial Medical Center UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Pathology UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salwa","family":"Khedr","sequence":"additional","affiliation":[{"name":"Department of Pathology UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cachia","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology\/Oncology, UMass Memorial Medical Center UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2458-9887","authenticated-orcid":false,"given":"Abhishek A.","family":"Mangaonkar","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"McGuiness","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Cardiovascular Medicine UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1850-9864","authenticated-orcid":false,"given":"Anne W.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Pathology UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M.","family":"Miron","sequence":"additional","affiliation":[{"name":"Department of Pathology UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Division of Hematology\/Oncology, UMass Memorial Medical Center UMass Chan Medical School  Worcester Massachusetts 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