Many patients who have hematologic malignancies depend on the donation of hematopoietic (blood) stem cells, and assessing donor stem cell health prospectively could be essential to successful transplantation.  

In a meta-analysis published in Bone Marrow Transplantation, Yiyu Xie, MD, and Vera Kazakova, MD, Hematology/Oncology fellows, under the direction of  Shyam Patel, MD, PhD, assistant professor of medicine in the Division of Hematology/Oncology, investigated the effects of donor-engrafted clonal hematopoiesis (blood cell mutations) in allogeneic and autologous stem cell transplantation.  

The team found that mutations from the donor cells for allogeneic stem cell transplant in patients with leukemia decreased the risk of relapse and, thus, appeared to be beneficial. However, mutations in autologous (self) donors were shown to be harmful and resulted in lower survival for patients undergoing autologous stem cell transplants for lymphoma or multiple myeloma. 

Their analysis suggests that prospective screening to evaluate for clonal hematopoiesis in donor hematopoietic stem cells could be beneficial.  

“Donor stem cell health may be critically important in the setting of stem cell transplantation for hematologic malignancies,” said Dr. Patel. “It is now known that clonal hematopoiesis of indeterminate potential (CHIP) is a precursor for myeloid neoplasms, and our study evaluated the risk of CHIP in donors on the health of transplant recipients.”