Identification of Patients With Age-Related Clonal Hematopoiesis (ARCH) Among Cancer Survivors

This is a non-randomized, single-centre, observational study assessing the incidence of ARCH in cancer survivors. Patients over the age of 60 who had or will receive chemotherapy and/or radiation therapy for solid or hematologic malignancies at the Princess Margaret Cancer Centre will be considered. Based on the time point of treatment, patients will either fall into a post or prior chemotherapy/radiation cohort. Peripheral blood will be taken and will be sequenced for ARCH DNA mutations. Patients who have ARCH-related mutations at a variable allele frequency (VAF) of at least 0.5% we will repeat the genetic sequencing yearly to assess changes in mutational spectrum and VAF over time.

• Age ≥ 60
• Completed chemotherapy and/or radiation therapy and are being followed at Princess Margaret Cancer Centre i) Patient must be in remission for > 3 months after completing chemotherapy or radiation ii) Predicted 5 year survival of >75% iii) Peripheral blood counts must have returned to normal as defined by:

• Platelets ≥ 100 x 109/L
• PMN ≥ 1 x 109/L

Or

• Prior to chemotherapy and/or radiation therapy at the Princess Margaret Cancer Centre.
• All histologically/cytologically proven tumour types (solid tumours and hematologic malignancies) will be eligible.
• Received or will receive regimens of chemotherapy or radiation with doses expected to produce transient myelosuppression (PMN<0.5x109/L) in at least 80% of treated patients (The identification and definition of appropriate myelosuppressive chemotherapy and radiation regimens will be at the discretion of the treating physician and will vary among disease sites).
• Patients must have the ability to understand the requirements of the study and provide written informed consent, which includes authorization for release of protected health information
• Patient must be willing to provide a peripheral blood sample.

Exclusion criteria

• Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.