Abstract
Clonal hematopoiesis is associated with increased risk of venous thromboembolism (VTE). The risk of VTE is high in patients with lymphoma and after autologous peripheral blood stem cell transplantation, and clonal hematopoiesis is present in many patients with lymphoma at autologous peripheral blood stem cell transplantation. We examined whether clonal hematopoiesis increases posttransplant VTE risk in patients with lymphoma. Our study included 557 patients with lymphoma who had survived 2 or more years after receiving autologous peripheral blood stem cell transplantation between 1999 and 2014. Clonal hematopoiesis was measured by targeted sequencing of cryopreserved peripheral blood stem cell product. Median age at stem cell transplantation was 54 years. Subdistribution hazard regression analysis with death as a competing risk was used to examine the association between clonal hematopoiesis in the peripheral blood stem cell product and post-autologous peripheral blood stem cell transplantation VTE. Clonal hematopoiesis was detected in 36.1% of patients. The 8-year cumulative incidence of VTE was 8.2% with clonal hematopoiesis vs 3.6% among patients without clonal hematopoiesis. The presence of PPM1D mutation (hazard ratio = 4.12, 95% CI = 1.55 to 10.92) or TP53 mutation (hazard ratio = 5.31, 95% CI = 1.54 to 18.35), with no clonal hematopoiesis as the referent, was associated with VTE risk in adjusted analysis.