Clonal hematopoiesis in 42 714 patients with nonhematologic cancer assessed for CH. (A) Restriction of full cohort of 42 714 patients to those living at least 2 weeks, followed at least 2 weeks, and not yet diagnosed with a hematologic malignancy for at least 2 weeks after CH assessment. A total of 39 510 patients were evaluated in all subsequent analysis. (B) Prevalence of frequently mutated genes in CH based on age decile. (C) Distribution of mosaic chromosome alterations (MCAs) out of 35 134 evaluated patients using FACETS-CH. Alterations of chromosomes 5, 7, and 17 are highlighted in red because of their frequent association with high-risk therapy-related myeloid neoplasms. (D) The percentage of patients with CH stratified by primary solid cancer diagnosis per age decile. (E) Percentage of patients with CH among patients exposed to drugs with specified anticancer mechanisms before assessment. Many patients were exposed to >1 drug mechanism. Data are from institutional pharmacy administration records which do not include anticancer therapies prescribed by non-MSK oncologists. (F) Density plots showing distribution of basic hematologic indices. Hemoglobin is reported in grams per deciliter. WBCs (white blood cells) and platelets are reported as 109 cells per liter. Vertical lines represent the median of each distribution. (G-H) Cumulative incidence of (G) hematologic malignancy and (H) death in patients with and without CH. HRs and P values were calculated using a multivariate competing risk regression, adjusting for age, gender, and cancer type.
