Clinically silent clonal cytogenetic abnormalities arising in patients treated for lymphoid neoplasms

• CCA in the post cytotoxic therapy setting are not always indicative of t-MN, can be “silent”.
• These “silent” CCA show some characteristic features differing from those in t-MN.
• Recognizing these “silent” CCA is critical to avoid unnecessary therapeutic intervention.

Newly emerged clonal cytogenetic abnormalities (CCA) in patients with prior cytotoxic therapy are highly concerning for therapy-related myeloid neoplasms (t-MN). In some patients, however, CCA appeared to be clinically “silent”. In this study, we describe 25 patients who developed CCA after they received cytotoxic therapies for lymphoid neoplasms but never developed t-MN. These clinically “silent” CCA were always present as single abnormalities, often detected in a small subset of cells, and tended to disappear over time. We conclude that the occurrence of CCA is not always associated with t-MN. Clinical correlation is essential to guide a proper management of these patients.