Impact of Exercise on Clonal Hematopoiesis

Area of Science:

• Oncology
• Genetics
• Exercise Physiology

Background:

• Clonal hematopoiesis (CH) is more common in cancer patients.
• CH is linked to an increased risk of all-cause mortality (ACM) in cancer patients.
• Currently, no interventions exist to mitigate the risks associated with CH.

Purpose of the Study:

• To determine if exercise can reduce the prevalence of CH in cancer patients.
• To investigate whether exercise can decrease the excess ACM risk in cancer patients with CH.

Main Methods:

• Genomic sequencing data and clinical information from 3,539 solid tumor patients (MSK-IMPACT) and 1,142 breast cancer patients (CANTO) were analyzed.
• Patients were categorized as exercisers (>0 MET-h/week) or nonexercisers (0 MET-h/week).
• A small-scale, remotely supervised exercise intervention was conducted in 4 cancer patients with CH.

Main Results:

• Exercise status did not significantly impact CH prevalence in either the MSK-IMPACT or CANTO cohorts.
• Cancer patients with CH exhibited a higher unadjusted hazard of ACM compared to those without CH.
• Patients with CH who exercised showed a reduced adjusted hazard of ACM compared to non-CH nonexercisers.

Conclusions:

• Exercise is not associated with a reduced burden of clonal hematopoiesis (CH) in cancer patients.
• Exercise demonstrably reduces the excess all-cause mortality (ACM) risk associated with CH in cancer patients.
• Further investigation into the exercise-CH relationship within cancer and other populations is necessary.