Therapy-related myeloid neoplasms
Assess risk through high sensitivity clonal hematopoiesis testing
As cancer treatments expand for many types of malignancies, clinicians face the growing challenge of identifying patients at risk for developing therapy-related myeloid neoplasms (t-MNs), which can emerge months or years after treatment.1,2,3
Cytotoxic chemotherapy, radiation, radionuclide therapies, and other genotoxic treatments may expand populations of hematopoietic stem cell clones with preexisting somatic driver mutations in a condition known as therapy-induced clonal hematopoiesis (t-CH). As these clones expand, the risk of developing t-MNs is increased for some patients.
Identifying these mutations — which are often present at extremely low levels long before cancer treatment begins — before treatment initiation is vital to understanding a patient’s risk of developing t-CH. But conventional next-generation sequencing often misses low-frequency clonal populations that can grow under treatment pressure. Lacking visibility into these emerging clones, opportunities for risk-informed treatment planning and monitoring can be missed.
High-sensitivity clonal hematopoiesis testing can assess t-MN risk and support precision oncology care by identifying driver mutations before they expand, monitoring clonal changes over time, and refining risk stratification.
High sensitivity clonal hematopoiesis test menu
High sensitivity clonal hematopoiesis
Designed around the needs of patients with solid tumors or who’ve gone through stem cell transplant, our first-in-class, high sensitivity clonal hematopoiesis assay analyzes peripheral blood using highly sensitive next-generation sequencing to detect somatic mutations in 37 genes with known associations to t-CH and progression risk. Notably, this panel includes DNA damage response genes often excluded from myeloid panels.
With a superior sensitivity that can detect 0.25% variant allele fraction (VAF), our assay can help determine whether variants detected by a ctDNA assay are associated with clonal hematopoiesis (CH) or tumor-derived. Distinguishing blood-cell-derived CH variants from tumor-derived alterations is critical for accurate interpretation of ctDNA results, appropriate disease classification, and informed treatment selection.
Additional information
Most patients with t-CH develop t-MN within two to three years after treatment. Using this test before therapy initiation and throughout the treatment empowers physicians and their patients to make informed treatment decisions.
Testing time points
- Prior to therapy
- Six months after treatment
- 12 months after treatment
- 24 months after treatment
- 36 months after treatment
Key testing
- HSCHP | High Sensitivity Clonal Hematopoiesis Panel, Next-Generation Sequencing, Blood
- Uses a highly sensitive next-generation sequencing method to detect single nucleotide variants (SNVs) and small deletions-insertions (delins) in 37 genes.
- Analyzes peripheral blood to detect somatic mutations known for their association with CH.
- Provides superior sensitivity (0.25%) for VAF detection compared to standard panels (2%–5%).
- Results can help inform decisions about the use of chemotherapy, radiation, or radionuclide therapies.
- Results can help guide personalized monitoring strategies to reduce therapy-related hematologic toxicities.
- Reduces the risk of false-positive liquid biopsy results that could lead to unnecessary PARP inhibitor treatment.
- Supports serial monitoring of emerging clones.
- Offers valuable prognostic information and helps inform eligibility for clinical trials.
References
- Patel SA, Zhu V, Gerber WK, Suzuki S, Barker C, Hutchinson L, et al. Ontogeny and natural history of therapy-related clonal hematopoiesis from a multidisciplinary CHIP clinic. Am J Hematol. 2026. doi:10.1002/ajh.70374
- Muhammad S, Shaukat A. CT-1297: Therapy-related myeloid neoplasms following CAR-T therapy: emerging patterns, risk factors, and clinical challenges. Clin Lymphoma Myeloma Leuk. 2026 Aug 01: Volume 26, Pages S1275-S1276
- Vidales Sepulveda Z, Bisbe ME, Cifuentes LB, et al. 126P Therapy-related myeloid neoplasms (t-MN) following PARP inhibitors (PARPi) in advanced epithelial ovarian cancer (EOC). ESMO Open, July 01, 2026, Volume 11, Article 108173.
- Coombs CC, Zehir A, Devlin SM, et al. Therapy-related clonal hematopoiesis in patients with non-hematologic cancers is common and associated with adverse clinical outcomes. Cell Stem Cell. 2017 Sep 7;21(3):374-382.e4. doi:10.1016/j.stem.2017.07.010. Epub 2017 Aug 10. PMID: 28803919; PMCID: PMC5591073.