Clonal hematopoiesis landscape in frequent blood donors

D Darja Karpova H Hector Huerga Encabo (6Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom) E Elisa Donato (1German Cancer Research Center (DKFZ), Stem Cells and Cancer, Heidelberg, Germany) S Silvia Calderazzo M Michael Scherer M Miriam Llorian-Sopena (10Bioinformatics and Biostatistics, The Francis Crick Institute, London, United Kingdom) A Aino-Maija Leppä R Roberto Würth (1Division of Stem Cells and Cancer, German Cancer Research Center, Heidelberg, Germany) P Patrick Stelmach (1German Cancer Research Center (DKFZ), Stem Cells and Cancer, Heidelberg, Germany) D Despoina Papazoglou (1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom) A Alessandra Ferrelli (1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom) S Steven Ngo (1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom) I Iuliia Kotova (11European Molecular Biology Laboratory, Hamburg, Germany) S Sabine Harenkamp (5Institute for Transfusion Medicine and Immunohematology, Goethe University Hospital Medical School, German Red Cross Blood Donor Service, Frankfurt, Germany) K Kai Zimmer (12Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria) D Dominik Wolf J Jasper Panten J John Reed (4Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO) A Adriana Przybylla (1Division of Stem Cells and Cancer, German Cancer Research Center, Heidelberg, Germany) T Torsten Tonn (5Institute for Transfusion Medicine and Immunohematology, Goethe University Hospital Medical School, German Red Cross Blood Donor Service, Frankfurt, Germany) A Annette Kopp-Schneider L Lars Velten J John F. DiPersio (Department of Medicine, Washington University School of Medicine, St. Louis) T Terrence N. Wong (2Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI) D Dominique Bonnet H Halvard Bonig A Andreas Trumpp

Abstract

Abstract Donor blood saves lives, yet the potential impact of recurrent large-volume phlebotomy on donor health and hematopoietic stem cells (HSCs) remains largely unexplored. In our study, we conducted a comprehensive screening of 217 older male volunteer donors with a history of extensive blood donation (>100 lifetime donations) to investigate the phenomenon of clonal hematopoiesis (CH). No significant difference in the overall incidence of CH was found in frequent donors (FDs) compared with sporadic donors (<10 lifetime donations; 212 donors). However, upon deeper analysis of mutations in DNMT3A, the most commonly affected gene in CH, we observed distinct mutational patterns between the FD and age/sex-matched control donor cohorts. Functional analysis of FD-enriched DNMT3A variants examined in CRISPR-edited human HSCs demonstrated their competitive outgrowth potential upon stimulation with erythropoietin (EPO), a hormone that increases in response to blood loss. In contrast, clones harboring leukemogenic DNMT3A R882 mutations increase upon stimulation with interferon gamma. Through concurrent mutational and immunophenotypic profiling of primary samples at single-cell resolution, a myeloid bias of premalignant R882 mutant HSCs was found, whereas no significant lineage bias was observed in HSCs harboring EPO-responsive DNMT3A variants. The latter exhibited preferential erythroid differentiation when persistent erythropoietic stress was applied to CRISPR-edited human HSC xenografts. Our data demonstrate a nuanced, ongoing Darwinian evolution at the somatic stem cell level, with EPO identified as a novel environmental factor that favors HSCs carrying certain DNMT3A mutations.

Article Details

Journal Blood
Volume / Issue Vol. 145, Issue 21
Published May 22, 2025
Pages 2411-2423
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (27)

D

Darja Karpova

H

Hector Huerga Encabo

6Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom

E

Elisa Donato

1German Cancer Research Center (DKFZ), Stem Cells and Cancer, Heidelberg, Germany

S

Silvia Calderazzo

M

Michael Scherer

M

Miriam Llorian-Sopena

10Bioinformatics and Biostatistics, The Francis Crick Institute, London, United Kingdom

A

Aino-Maija Leppä

R

Roberto Würth

1Division of Stem Cells and Cancer, German Cancer Research Center, Heidelberg, Germany

P

Patrick Stelmach

1German Cancer Research Center (DKFZ), Stem Cells and Cancer, Heidelberg, Germany

D

Despoina Papazoglou

1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom

A

Alessandra Ferrelli

1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom

S

Steven Ngo

1Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, United Kingdom

I

Iuliia Kotova

11European Molecular Biology Laboratory, Hamburg, Germany

S

Sabine Harenkamp

5Institute for Transfusion Medicine and Immunohematology, Goethe University Hospital Medical School, German Red Cross Blood Donor Service, Frankfurt, Germany

K

Kai Zimmer

12Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria

D

Dominik Wolf

J

Jasper Panten

J

John Reed

4Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO

A

Adriana Przybylla

1Division of Stem Cells and Cancer, German Cancer Research Center, Heidelberg, Germany

T

Torsten Tonn

5Institute for Transfusion Medicine and Immunohematology, Goethe University Hospital Medical School, German Red Cross Blood Donor Service, Frankfurt, Germany

A

Annette Kopp-Schneider

L

Lars Velten

J

John F. DiPersio

Department of Medicine, Washington University School of Medicine, St. Louis

T

Terrence N. Wong

2Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI

D

Dominique Bonnet

H

Halvard Bonig

A

Andreas Trumpp