Dr. Alexander Bick, Professor at the Vanderbilt University Medical Center, talks about clonal hematopoiesis.
Interview conducted by Ivanhoe Broadcast News in 2023.
Can you start by giving any background of Phil’s diagnosis or was it difficult to diagnose Phil after he’d seen other doctors that might have told him other things?
Bick: Clonal hematopoiesis is really a silent disease. It happens in our blood cells. Just looking at a patient, you would never know that they had it. We often find patients have mutations in their blood and that mutation is really what helps us diagnose their disease.
What led you to his diagnosis?
Bick: In his case, he was getting evaluated because he had some abnormal blood counts and as part of that evaluation, we, sent genetic testing. In that genetic testing, we found a mutated blood cell. That mutation can go on to cause cancer, but long before you get blood cancer you can have a mutation and that’s what we found in him.
How common is what he had?
Bick: Clonal hematopoiesis is present in about 10 percent of adults over 70, so it’s extraordinarily common.
Can you talk about his exact treatment? What forms he was receiving, was it IVs or tablets?
Bick: With patients who have clonal hematopoiesis, what we’re most worried about is what might happen to them rather than specific treatments that we can offer today. In his case, we’re very focused on looking at his blood counts and making sure that his blood counts are not evolving towards blood cancer. We’re also very interested in his heart disease risk and making sure that he is optimally treated and that he’s on medicines that lower blood pressure, medicines that lower cholesterol, and other medicines that might prevent him from getting a heart attack.
Does age matter with this disease?
Bick: Clonal hematopoiesis is intimately linked to aging because with age, our stem cells, the cells that makeup all the blood in our body, divide. Every time these cells divide, they acquire new mutations. Most of these mutations don’t affect us one way or the other, but occasionally, you get a mutation in the wrong place, at the wrong time and that’s what gives rise to this growth. This growth is the disease that we call clonal hematopoiesis.
What’s the prognosis?
Bick: Patients who have clonal hematopoiesis have about twice the risk of dying of people without it. But what’s interesting is that they don’t die of blood cancer, they die of heart disease, and they die of other inflammatory diseases. What we are really focused on in patients with clonal hematopoiesis is trying to make sure that we’re treating all the other conditions in addition to focusing on blood cancer.
How’s Phil doing now? Do you feel hopeful for him?
Alexander Bick: I think we’ve been watching him for a good while now and his clone does not seem to be evolving towards blood cancer. We’ve been monitoring him for a while now and following his blood counts very closely, it does not look like he’s evolving towards blood cancer. We’re very hopeful that he’ll continue to live a normal lifespan. Something that doctors say, keep going.
Are there any other important things about Phil or anything that I missed that is important?
Bick: I think this disease that we call clonal hematopoiesis was only really discovered about five years ago. Just in the past five years, we’ve been getting a much better sense of what mutations in the blood are harmful and cause blood cancer and which mutations cause heart disease and other conditions. We’re excited to continue to learn more from patients like Phil.
END OF INTERVIEW
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