{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:00:46Z","timestamp":1792612846913,"version":"4.5.0"},"reference-count":49,"publisher":"American Society of Hematology","issue":"12","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Chronic lymphocytic leukemia (CLL) and clonal hematopoiesis (CH) both commonly occur in older individuals. To characterize CH in CLL, 620 patients were analyzed (CLL12 [ibrutinib vs placebo] and CLL14 [venetoclax-obinutuzumab (Ven-Obi) vs chlorambucil-obinutuzumab (Clb-Obi)]) using error-corrected next-generation sequencing with a variant allele frequency (VAF) threshold of 0.5%. Median follow-up was 76.1 months, and median age was 68 years. CH was detected in 58.2% of patients, most commonly affecting DNMT3A, TET2, TP53, and ASXL1. Longitudinal analysis in CLL14 revealed persistence of the majority of CH clones during follow-up, whereas in more than half of the patients, additional CH mutations were detected. BAX- and U2AF1-mutated CH emerged during Ven-Obi exposure, and PPM1D-mutated CH emerged during Clb-Obi exposure, highlighting treatment gene\u2013specific selection. Clonal fitness analyses revealed accelerated CH clone expansion during therapy, followed by slower growth after treatment. In vitro, genetically modified CD34+ hematopoietic stem\/progenitor cells harboring BAX mutations showed enhanced survival and decreased apoptosis. CH was associated with neutropenia, and all patients with Richter transformation (RT; n = 11) had CH. Whole-exome sequencing delineated the contribution of CH mutations in 2 of 4 investigated patients with RT. Large CH clone size (&amp;gt;10% VAF) was independently associated with shorter overall survival with placebo (P = .049) and shorter progression-free survival with Clb-Obi after adjusting for age, immunoglobulin heavy chain variable status, and del(17p). In contrast, CH had no prognostic impact in patients receiving targeted therapies. This study demonstrates the high prevalence of CH, highlights its differential impact across CLL therapies, and underscores its adverse influence on patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2025029905","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T12:28:36Z","timestamp":1768307316000},"page":"1323-1337","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":15,"title":["The landscape and evolution of clonal hematopoiesis in chronic lymphocytic leukemia"],"prefix":"10.1182","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9895-0570","authenticated-orcid":false,"given":"Othman","family":"Al-Sawaf","sequence":"first","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-4984","authenticated-orcid":false,"given":"Benjamin N.","family":"Locher","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8868-2533","authenticated-orcid":false,"given":"Friederike","family":"Christen","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Hablesreiter","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-612X","authenticated-orcid":false,"given":"Anantharamanan","family":"Rajamani","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8848-6655","authenticated-orcid":false,"given":"Sandra","family":"Robrecht","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Zhang","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Fink","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugen","family":"Tausch","sequence":"additional","affiliation":[{"name":"4Division of CLL, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Schneider","sequence":"additional","affiliation":[{"name":"4Division of CLL, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Ritgen","sequence":"additional","affiliation":[{"name":"5Department of Internal Medicine II (Hematology\/Oncology), University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Anton","family":"Kreuzer","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8912-6115","authenticated-orcid":false,"given":"Klara","family":"Kopp","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Elisa","family":"Mertz","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Fustero-Torre","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Kleo","sequence":"additional","affiliation":[{"name":"6Department of Pathology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2188-6835","authenticated-orcid":false,"given":"John","family":"Seymour","sequence":"additional","affiliation":[{"name":"7Peter MacCallum Cancer Center, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piers","family":"Blombery","sequence":"additional","affiliation":[{"name":"7Peter MacCallum Cancer Center, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Bullinger","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Chyla","sequence":"additional","affiliation":[{"name":"8AbbVie Inc, North Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Yong","family":"Jin","sequence":"additional","affiliation":[{"name":"9Genentech, Inc, South San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanwen","family":"Jiang","sequence":"additional","affiliation":[{"name":"9Genentech, Inc, South San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Stilgenbauer","sequence":"additional","affiliation":[{"name":"4Division of CLL, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-4455","authenticated-orcid":false,"given":"Michael","family":"Hallek","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Eichhorst","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-0304","authenticated-orcid":false,"given":"Petra","family":"Langerbeins","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Fischer","sequence":"additional","affiliation":[{"name":"1Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany"},{"name":"2German CLL Study Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5553-1173","authenticated-orcid":false,"given":"Frederik","family":"Damm","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Oncology, and Cancer Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"},{"name":"10German Cancer Consortium (DKTK), Partner Site, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"10453","key":"2026031911222570700_bib1","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/S0140-6736(24)00595-6","article-title":"Chronic lymphocytic leukaemia","volume":"404","author":"Jain","year":"2024","journal-title":"Lancet"},{"issue":"19","key":"2026031911222570700_bib2","doi-asserted-by":"crossref","first-page":"e180065","DOI":"10.1172\/JCI180065","article-title":"Clonal hematopoiesis and hematological malignancy","volume":"134","author":"Dunn","year":"2024","journal-title":"J Clin Invest"},{"issue":"1","key":"2026031911222570700_bib3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1182\/blood-2015-03-631747","article-title":"Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes","volume":"126","author":"Steensma","year":"2015","journal-title":"Blood"},{"issue":"5","key":"2026031911222570700_bib4","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2200310","article-title":"Prediction of risk for myeloid malignancy in clonal hematopoiesis","volume":"2","author":"Weeks","year":"2023","journal-title":"NEJM Evid"},{"key":"2026031911222570700_bib5","doi-asserted-by":"crossref","first-page":"594556","DOI":"10.3389\/fimmu.2020.594556","article-title":"Immune dysfunctions and immune-based therapeutic interventions in chronic lymphocytic leukemia","volume":"11","author":"Griggio","year":"2020","journal-title":"Front Immunol"},{"issue":"1","key":"2026031911222570700_bib6","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.beha.2010.01.004","article-title":"Autoimmune complications in chronic lymphocytic leukaemia (CLL)","volume":"23","author":"Zent","year":"2010","journal-title":"Best Pract Res Clin Haematol"},{"issue":"2","key":"2026031911222570700_bib7","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1038\/s44161-021-00015-3","article-title":"Clonal hematopoiesis in cardiovascular disease and therapeutic implications","volume":"1","author":"Tall","year":"2022","journal-title":"Nat Cardiovasc Res"},{"issue":"23","key":"2026031911222570700_bib8","doi-asserted-by":"crossref","first-page":"5949","DOI":"10.1182\/bloodadvances.2024013414","article-title":"Myeloid clonal hematopoiesis of indeterminate potential in patients with chronic lymphocytic leukemia","volume":"8","author":"Vijenthira","year":"2024","journal-title":"Blood Adv"},{"issue":"1","key":"2026031911222570700_bib9","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/bjh.18129","article-title":"Clonal haematopoiesis as a risk factor for therapy-related myeloid neoplasms in patients with chronic lymphocytic leukaemia treated with chemo-(immuno)therapy","volume":"198","author":"Voso","year":"2022","journal-title":"Br J Haematol"},{"issue":"8","key":"2026031911222570700_bib10","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1182\/blood.2021012775","article-title":"Clonal hematopoiesis, myeloid disorders and BAX-mutated myelopoiesis in patients receiving venetoclax for CLL","volume":"139","author":"Blombery","year":"2022","journal-title":"Blood"},{"issue":"23","key":"2026031911222570700_bib11","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1056\/NEJMoa1815281","article-title":"Venetoclax and obinutuzumab in patients with CLL and coexisting conditions","volume":"380","author":"Fischer","year":"2019","journal-title":"N Engl J Med"},{"issue":"2","key":"2026031911222570700_bib12","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1182\/blood.2021010845","article-title":"The CLL12 trial: ibrutinib vs placebo in treatment-na\u00efve, early-stage chronic lymphocytic leukemia","volume":"139","author":"Langerbeins","year":"2022","journal-title":"Blood"},{"issue":"11","key":"2026031911222570700_bib13","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1038\/s41588-022-01140-w","article-title":"Molecular map of chronic lymphocytic leukemia and its impact on outcome","volume":"54","author":"Knisbacher","year":"2022","journal-title":"Nat Genet"},{"issue":"11","key":"2026031911222570700_bib14","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1038\/s41588-022-01211-y","article-title":"Whole-genome sequencing of chronic lymphocytic leukemia identifies subgroups with distinct biological and clinical features","volume":"54","author":"Robbe","year":"2022","journal-title":"Nat Genet"},{"issue":"7","key":"2026031911222570700_bib15","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1182\/blood.2022017661","article-title":"Associations of clonal hematopoiesis with recurrent vascular events and death in patients with incident ischemic stroke","volume":"141","author":"Arends","year":"2023","journal-title":"Blood"},{"issue":"6","key":"2026031911222570700_bib16","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1038\/s41375-024-02253-3","article-title":"Dynamics of clonal hematopoiesis under DNA-damaging treatment in patients with ovarian cancer","volume":"38","author":"Arends","year":"2024","journal-title":"Leukemia"},{"issue":"12","key":"2026031911222570700_bib17","doi-asserted-by":"crossref","first-page":"2727","DOI":"10.1038\/s41375-024-02374-9","article-title":"Characterisation and prognostic impact Of ZRSR2 mutations in myeloid neoplasms","volume":"38","author":"Yacout","year":"2024","journal-title":"Leukemia"},{"issue":"4","key":"2026031911222570700_bib18","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1038\/s41375-021-01469-x","article-title":"Modeling clonal hematopoiesis in umbilical cord blood cells by CRISPR\/Cas9","volume":"36","author":"Christen","year":"2022","journal-title":"Leukemia"},{"issue":"4","key":"2026031911222570700_bib19","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1200\/JCO.24.00975","article-title":"Ibrutinib in early-stage chronic lymphocytic leukemia: the randomized, placebo-controlled, double-blind, phase III CLL12 trial","volume":"43","author":"Langerbeins","year":"2025","journal-title":"J Clin Oncol"},{"issue":"26","key":"2026031911222570700_bib20","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1182\/blood.2019004492","article-title":"Prognostic and predictive impact of genetic markers in patients with CLL treated with obinutuzumab and venetoclax","volume":"135","author":"Tausch","year":"2020","journal-title":"Blood"},{"issue":"8","key":"2026031911222570700_bib21","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1038\/s41591-022-01927-8","article-title":"Detection of early seeding of Richter transformation in chronic lymphocytic leukemia","volume":"28","author":"Nadeu","year":"2022","journal-title":"Nat Med"},{"issue":"1","key":"2026031911222570700_bib22","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1038\/s41591-022-02113-6","article-title":"Evolutionary history of transformation from chronic lymphocytic leukemia to Richter syndrome","volume":"29","author":"Parry","year":"2023","journal-title":"Nat Med"},{"issue":"16","key":"2026031911222570700_bib23","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1056\/NEJMoa2413361","article-title":"Tumor-infiltrating clonal hematopoiesis","volume":"392","author":"Pich","year":"2025","journal-title":"N Engl J Med"},{"issue":"7","key":"2026031911222570700_bib24","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1038\/s41375-022-01613-1","article-title":"The 5th edition of the World Health Organization classification of haematolymphoid tumours: myeloid and histiocytic\/dendritic neoplasms","volume":"36","author":"Khoury","year":"2022","journal-title":"Leukemia"},{"issue":"26","key":"2026031911222570700_bib25","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1056\/NEJMoa1408617","article-title":"Age-related clonal hematopoiesis associated with adverse outcomes","volume":"371","author":"Jaiswal","year":"2014","journal-title":"N Engl J Med"},{"issue":"21","key":"2026031911222570700_bib26","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1182\/blood.2021011320","article-title":"Clinical relevance of clonal hematopoiesis in persons aged \u226580 years","volume":"138","author":"Rossi","year":"2021","journal-title":"Blood"},{"issue":"7939","key":"2026031911222570700_bib27","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/s41586-022-05448-9","article-title":"Common and rare variant associations with clonal haematopoiesis phenotypes","volume":"612","author":"Kessler","year":"2022","journal-title":"Nature"},{"issue":"suppl 1","key":"2026031911222570700_bib28","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1182\/blood-2024-205118","article-title":"Causes and consequences of clonal hematopoiesis with unknown drivers in 409,553 whole-genome sequenced UK Biobank participants","volume":"144","author":"Wen","year":"2024","journal-title":"Blood"},{"issue":"11","key":"2026031911222570700_bib29","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1182\/blood.2021011323","article-title":"Relationship between clone metrics and clinical outcome in clonal cytopenia","volume":"138","author":"Gall\u00ec","year":"2021","journal-title":"Blood"},{"issue":"14","key":"2026031911222570700_bib30","first-page":"1599","article-title":"Clonal hematopoiesis and risk for hematologic malignancy","volume":"136","author":"Warren","year":"2020","journal-title":"Blood"},{"issue":"suppl 1","key":"2026031911222570700_bib31","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1182\/blood-2024-210404","article-title":"Compartmentalized niche and spatially heterogenous inflammatory landscape regulate Tet2+\/-- mediated clonal hematopoiesis","volume":"144","author":"Lee","year":"2024","journal-title":"Blood"},{"issue":"suppl 1","key":"2026031911222570700_bib32","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1182\/blood-2023-182522","article-title":"CAR19 therapy drives expansion of clonal hematopoiesis and associated cytopenias","volume":"142","author":"Hamilton","year":"2023","journal-title":"Blood"},{"issue":"2","key":"2026031911222570700_bib33","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa1701719","article-title":"Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease","volume":"377","author":"Jaiswal","year":"2017","journal-title":"N Engl J Med"},{"issue":"9","key":"2026031911222570700_bib34","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1001\/jamacardio.2021.1678","article-title":"Association of diet quality with prevalence of clonal hematopoiesis and adverse cardiovascular events","volume":"6","author":"Bhattacharya","year":"2021","journal-title":"JAMA Cardiol"},{"issue":"6465","key":"2026031911222570700_bib35","doi-asserted-by":"crossref","first-page":"eaan4673","DOI":"10.1126\/science.aan4673","article-title":"Clonal hematopoiesis in human aging and disease","volume":"366","author":"Jaiswal","year":"2019","journal-title":"Science"},{"issue":"9","key":"2026031911222570700_bib36","first-page":"805","article-title":"Loss-of-function mutations in Dnmt3a and Tet2 lead to accelerated atherosclerosis and concordant macrophage phenotypes","volume":"2","author":"Rauch","year":"2023","journal-title":"Nat Cardiovasc Res"},{"issue":"1","key":"2026031911222570700_bib37","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1182\/asheducation-2018.1.264","article-title":"Clinical consequences of clonal hematopoiesis of indeterminate potential","volume":"2018","author":"Steensma","year":"2018","journal-title":"Hematology"},{"issue":"22","key":"2026031911222570700_bib38","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1182\/blood.2019000840","article-title":"Hypertension and incident cardiovascular events following ibrutinib initiation","volume":"134","author":"Dickerson","year":"2019","journal-title":"Blood"},{"issue":"5","key":"2026031911222570700_bib39","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jaccao.2023.09.002","article-title":"Cardiovascular toxicities of BTK inhibitors in chronic lymphocytic leukemia: JACC: CardioOncology State-of-the-Art Review","volume":"5","author":"Quartermaine","year":"2023","journal-title":"JACC CardioOncol"},{"issue":"8","key":"2026031911222570700_bib40","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1182\/blood.2022018818","article-title":"Detailed safety profile of acalabrutinib vs ibrutinib in previously treated chronic lymphocytic leukemia in the ELEVATE-RR trial","volume":"142","author":"Seymour","year":"2023","journal-title":"Blood"},{"issue":"7","key":"2026031911222570700_bib41","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1200\/JCO.22.00857","article-title":"Clonal hematopoiesis and risk of incident lung cancer","volume":"41","author":"Tian","year":"2023","journal-title":"J Clin Oncol"},{"issue":"7","key":"2026031911222570700_bib42","doi-asserted-by":"crossref","first-page":"e2300070","DOI":"10.1200\/PO.23.00070","article-title":"Associations between cancer predisposition mutations and clonal hematopoiesis in patients with solid tumors","author":"Franch-Exp\u00f3sito","year":"2023","journal-title":"JCO Precis Oncol"},{"issue":"8","key":"2026031911222570700_bib43","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1038\/s41588-022-01121-z","article-title":"Genome-wide analyses of 200,453 individuals yield new insights into the causes and consequences of clonal hematopoiesis","volume":"54","author":"Kar","year":"2022","journal-title":"Nat Genet"},{"issue":"10","key":"2026031911222570700_bib44","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1038\/leu.2016.113","article-title":"Effect of first-line treatment on second primary malignancies and Richter's transformation in patients with CLL","volume":"30","author":"Maurer","year":"2016","journal-title":"Leukemia"},{"issue":"1","key":"2026031911222570700_bib45","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41408-023-00784-z","article-title":"Risk of second primary malignancies in patients with chronic lymphocytic leukemia: a population-based study in the Netherlands, 1989-2019","volume":"13","author":"van der Straten","year":"2023","journal-title":"Blood Cancer J"},{"issue":"8","key":"2026031911222570700_bib46","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1038\/s41408-021-00532-1","article-title":"Cause of death in patients with newly diagnosed chronic lymphocytic leukemia (CLL) stratified by the CLL-International Prognostic Index","volume":"11","author":"Wang","year":"2021","journal-title":"Blood Cancer J"},{"issue":"5","key":"2026031911222570700_bib47","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1038\/s41556-019-0314-5","article-title":"U2AF1 mutations induce oncogenic IRAK4 isoforms and activate innate immune pathways in myeloid malignancies","volume":"21","author":"Smith","year":"2019","journal-title":"Nat Cell Bio"},{"issue":"7","key":"2026031911222570700_bib48","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/s41419-021-03573-3","article-title":"U2AF1 mutation promotes tumorigenicity through facilitating autophagy flux mediated by FOXO3a activation in myelodysplastic syndromes","volume":"12","author":"Zhu","year":"2021","journal-title":"Cell Death Dis"},{"issue":"12","key":"2026031911222570700_bib49","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1038\/leu.2010.218","article-title":"Therapy-related myelodysplastic syndrome and acute myeloid leukemia following fludarabine combination chemotherapy","volume":"24","author":"Carney","year":"2010","journal-title":"Leukemia"}],"container-title":["Blood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/147\/12\/1323\/2509431\/blood_bld-2025-029905r1-main.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ashpublications.org\/blood\/article-pdf\/147\/12\/1323\/2509431\/blood_bld-2025-029905r1-main.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:22:38Z","timestamp":1773933758000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/blood\/article\/147\/12\/1323\/557450\/The-landscape-and-evolution-of-clonal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":49,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,3,19]]}},"URL":"https:\/\/doi.org\/10.1182\/blood.2025029905","relation":{},"ISSN":["0006-4971","1528-0020"],"issn-type":[{"value":"0006-4971","type":"print"},{"value":"1528-0020","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3,19]]},"published":{"date-parts":[[2026,3,19]]}}}