TP53-Mutated Clonal Hematopoiesis Drives Pro-Inflammatory Phenotype and Predicts Poor Outcomes After CAR T-Cell Therapy

Highlight

– TP53-mutated clonal hematopoiesis of indeterminate potential (CHIP) predicts adverse clinical outcomes post-CAR T-cell therapy.
– TP53-mutant clones exhibit expansion after CAR T infusion and associate with pro-inflammatory serum proteomic signatures.
– TP53 CHIP correlates with hematologic toxicity, including thrombocytopenia and anemia, and higher baseline CAR-HEMATOTOX scores.
– Monitoring of TP53-mutated CHIP clones may identify patients at risk for treatment-emergent myeloid neoplasms and guide risk-adapted management.

Study Background