Clonal Hematopoiesis Across the Cancer Treatment Continuum: A Scoping Review of Clonal Selection, Evolution, and Clinical Outcomes

Background

Clonal hematopoiesis (CH) is characterized by the proliferation of blood cell clones that possess acquired genetic modifications. While therapy-related CH refers to CH detected in the setting of prior or current treatment in cancer populations, therapy-selected CH demands demonstration that treatment preferentially expanded or maintained an extant clone; therapy-induced CH requires evidence of de novo treatment-associated mutation supported by serial sampling and mutational-signature analyses.

Objective

To map evidence distinguishing therapy-related, therapy-selected and therapy-induced CH across cancer treatment, including clonal dynamics, genomic features, clinical outcomes and surveillance gaps.

Methods