2023-05-05 09:26:55
Forty percent of all people over the age of 60 have one or more errors in the DNA of their blood cells, which are associated with leukaemia. Yet very few people actually develop the disease. In Cancer Cell, researchers from Radboudumc, UMCG and IKNL show exactly which errors or combinations of errors increase the risk of cancer.
When a mistake occurs in the DNA of a blood cell by accident, this cell can grow and divide faster than other blood cells. Dividing faster is also a property of tumor cells. Yet such blood cells with a mistake do not immediately turn into cancer. In fact, it now appears that blood cells with errors associated with leukemia are common in people who have no complaints at all: in forty percent of the over-60s.
A team of researchers, including Joop Jansen and Aniek de Graaf from Radboudumc, and Gerwin Huls and Isabelle van Zeventer from UMC Groningen, wanted to know when blood cells with errors do turn into tumor cells. That was not yet known. For their study, they analyzed the DNA of more than 7000 blood samples from 3359 people over the age of sixty from the Groningen Lifelines cohort. Two or three samples were available from the participants, each with almost four years between them, so that the researchers could track the development of the blood cells with errors.
Implications
The study shows that the presence of groups of cells with errors increases the risk of leukemia. These cells are also a risk factor for inflammatory diseases that are common with aging, such as cardiovascular disease and COPD. The researchers show exactly which DNA errors cause the fastest growth of blood cells and the highest risk of blood cancer, such as an error in the JAK2 gene. They also show that the combination with an abnormality of the blood, such as anemia, increases the risk of cancer.
Many other data were also known about all the people who participated in the study. For example, whether they smoke, how much alcohol they drink, what medicines they take and what work they do. The researchers found no link between the increase in blood cells with errors in the DNA and factors known to increase the risk of cancer, such as smoking, alcohol intake and obesity.
According to laboratory specialist Aniek de Graaf, it is currently not useful to screen all over-60s for errors in their blood cells. ‘As far as we’re concerned, that doesn’t make much sense if you’re healthy. You can’t do anything about those mistakes. We see no association with risk factors, such as smoking. In addition, mistakes increase the risk of leukemia, but the risk is still very small. Only when you go to the doctor with complaints is an analysis of blood cells important, because this can have consequences for the treatment and monitoring the course.’
Now that it is known which specific groups run a very high risk, a first step has been taken towards prevention. Professor of Experimental Hematology Joop Jansen: ‘With our follow-up research we are looking further for genetic factors and environmental factors that influence the development of leukemia, especially in people with a high risk.’
About the publication
This research was published in Cancer Cell: Evolutionary landscape of clonal hematopoiesis in 3359 individuals from the general population. Isabelle van Zeventer, Aniek de Graaf, Jonas Salzbrunn, Ilja Nolte, Priscilla Kamphuis, Avinash Dinmohamed, Bert van der Reijden, Jan Jacob Schuringa, Joop Jansen, Gerwin Huls.
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