在患有固体瘤的患者中,癌症治疗后的克隆性血液形成和心血管疾病风险
Derek Shyr1,2, Yash Pershad2, Kun Zhao2
1Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham.
JAMA oncology
|January 8, 2026
概括
不确定潜力的克隆性血液形成 (CHIP) 在接受治疗的癌症患者中显著增加心血管疾病的风险. 识别CHIP状态可能会增强癌症幸存者的心脏瘤治疗.
科学领域:
- 心脏瘤学是一门专业.
- 血液学 血液学 血液学
- 基因组学就是基因组学.
背景情况:
- 癌症幸存者因癌症治疗而面临心血管疾病 (CVD) 风险增加.
- 不确定潜力的克隆性血液形成 (CHIP),一种血液疾病,在癌症患者中更为常见,并且独立地增加了心血管疾病的风险.
- CHIP对癌症患者治疗相关心血管疾病毒性的影响尚不清楚.
研究的目的:
- 在接受化疗,放射治疗或免疫治疗的固体瘤患者中研究CHIP和心血管疾病风险之间的关联.
- 在CHIP的癌症患者中进行心血管疾病风险评估时考虑竞争性风险.
主要方法:
- 一项队列研究利用了BioVU,将电子健康记录与250,038名参与者的全基因组测序数据联系起来.
- 符合条件的参与者具有原发性固体瘤,并接受癌症治疗,不包括先前的血液恶性瘤.
- 通过全基因组测序识别CHIP变异;在治疗后跟踪心血管疾病事件.
主要成果:
- 在8004名参与者中,6.9%的人患有CHIP.
- 与非CHIP个人相比,CHIP与10年内心力衰竭和缺血性心血管疾病的累积发病率更高有关.
- CHIP与心力衰竭风险增加有关 (sHR,1.26;P=.03) 并显示强化化疗与心力衰竭风险的显著相互作用.
结论:
- 在接受癌症治疗的固体瘤患者中,CHIP与心血管疾病风险增加有关.
- 将CHIP状态纳入患者评估可以完善癌症幸存者的心脏瘤治疗策略.
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