Some kidney cancer patients may be at increased risk of heart-related events such as heart attack and stroke, and further research into the link between clonal hematopoiesis and heart health may improve outcomes for these patients Experts have argued that there is.
Maxine Sun, a researcher at the Rank Center for Genitourinary Oncology at Dana-Farber Cancer Institute in Boston, presented on this topic at the 2023 International Kidney Cancer Symposium.
“Cardiovascular health is becoming increasingly important for patients diagnosed with kidney cancer, as the number of treatments available for primary and subsequent treatment is increasing. Clonal hematopoiesis may influence risk. “It seems like there are a lot of things going on,” Sun said in his presentation. ”
Clonal hematopoiesis refers to when a patient has an excess of blood cells from one group. This can happen even if you don’t have cancer. People with clonal hematopoiesis often carry the TET2 mutation in their blood cells, which increases their chances of developing heart failure. Additionally, when certain immune cells called macrophages don’t have enough TET2, levels of a molecule called interleukin-1β, which causes inflammation, can increase, making the body more susceptible to inflammation.
“As a person ages, an increasing number of somatic mutations (changes in DNA that occur after conception) accumulate in tissues, most of which are insignificant. It may also give you this adaptability advantage,” Sun said. “When this process occurs in the hematopoietic system, the majority of circulating blood cells are derived from this single mutated stem cell, and this particular proliferation is called clonal hematopoiesis.”
Clonal hematopoiesis is known as a biomarker for the development and progression of blood cancers, Sun pointed out. Additionally, results from a 2014 study showed that clonal hematopoiesis increases all-cause mortality (death from any cause) and the risk of developing coronary heart disease (narrowing or occlusion of the coronary arteries) and ischemic stroke in the general population. showed an increase in (If a blood clot blocks an artery leading to the brain).
“What was surprising and unexpected about that study was that when we looked a little deeper, we found that the causes of death caused by driving, which increased the risk of all-cause mortality, were actually not caused by somatic cancer. “It turned out that most of the cases were caused by accidents, as well as coronary heart disease and ischemic stroke,” Sun said.
The Sun also covered mosaic chromosomal changes in detail. This refers to changes or abnormalities in a person’s chromosomes that are not the same in all cells of the body. She noted that mosaic loss of the Y chromosome is associated with increased all-cause mortality, Alzheimer’s disease, autoimmune diseases, diabetes, cancer, and cardiovascular events.
Additionally, mosaic chromosomal changes on autosomes (or associated with the 22 numbered pairs of chromosomes found in most human cells) are associated with increased rates of blood cancers and all-cause mortality. It has been.
The results of a 2023 study specifically targeting renal cell carcinoma patients Cancer epidemiology, biomarkers, and prevention Sun and colleagues showed that people with mosaic chromosomal changes have an increased risk of death from cardiovascular and coronary artery disease causes.
Based on the current literature and data on the association between clonal hematopoiesis and cardiovascular health, future research will help us better understand this correlation and identify kidneys that may be at higher risk for poor cardiovascular outcomes. The plan is to identify patients with cancer, Sun said.
“We use institutional data, such as Dana-Farber Institute, to determine cardiovascular outcomes in patients diagnosed with kidney cancer, whether constant potential clonal hematopoiesis (CHIP) or (other biomarkers). I would suggest examining the association of clonal hematopoiesis, whether in the Cancer Institute cohort, and likely in a larger population-based cohort with genomic data. “Reproducing this would strengthen the robustness of this marker,” Sun concluded.
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