# EARLY DETECTION OF CLONAL HEMATOPOIESIS AND LEUKEMIA ASSOCIATED MUTATIONS IN WTC EXPOSED FIREFIGHTERS AFTER THE 9/11 ATTACKS

> **NIH ALLCDC U01** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2022 · $488,632

## Abstract

ABSTRACT
The terrorist attacks on the World Trade Center (WTC) created an unprecedented environmental exposure to
WTC aerosolized dust and gases that contained known and suspected carcinogens including polycyclic aromatic
hydrocarbons, polychlorinated biphenyls, furans, dioxins and asbestos. Studies from our group have reported
an excess of cancer cases in the WTC-exposed Fire Department of the City of New York (FDNY) firefighters,(2,
3) including a trend towards higher incidence of leukemia and multiple myeloma. We continue to prospectively
follow the entire FDNY cohort of firefighters for cancer incidence and have built a biorepository of samples
consisting of fractionated blood components and serum from 2000+ WTC-exposed firefighters and non-WTC-
exposed firefighter controls. Using this cohort, we have conducted preliminary studies in 781 WTC-exposed
firefighters that demonstrate a significantly higher prevalence of monoclonal gammopathy of undetermined
significance (MGUS), a precursor for multiple myeloma. (4) Furthermore, we have conducted deep targeted
genome sequencing of a pilot cohort of WTC-exposed firefighters (N=481) and non-WTC-exposed age matched
firefighter controls (N=52). We observed a high incidence of Clonal hematopoiesis (CH) and leukemia associated
mutations (57/481; 12%) in WTC-exposed firefighters. The rate of mutations in controls was 2% and is
comparable to age matched controls in published studies (5, 6). Clonal hematopoiesis (CH) is acquisition of
leukemia associated somatic mutations that carry increase risk of hematologic cancer as well as all-cause
mortality. The mutations seen in WTC-exposed firefighters affected DNMT3A, TET2, TP53, Splicing and other
commonly recurrently mutated genes. These mutations suggest a high rate of CH, and CH in other cohorts has
been shown to be associated with risk for development of myeloid neoplasms, inflammatory conditions and heart
diseases. We now propose to comprehensively determine the prevalence of CH in a large FDNY WTC-exposed
cohort and study the molecular and cellular mechanisms of damage caused by WTC particulate matter (WTC-
PM). Aim 1 will determine the prevalence of clonal hematopoiesis mutations using deep targeted sequencing in
a large cohort of WTC-exposed firefighter and 2 cohorts of control samples (non-WTC firefighters and non-
firefighter age matched controls). Mutations will be correlated with clinical variables such as level of WTC
exposure, age, serial blood counts, smoking history and other clinical characteristics. Aim 2 will determine the
functional effects of WTC particulate matter on development of clonal hematopoiesis in vivo by using mouse
models with commonly mutated TET2 and DNMT3A genes. Lastly, aim 3 will determine the effect of WTC-PM
exposure on cellular changes at the single molecule level to assess the mechanisms and magnitude of DNA
damage in exposed cells. These results will further our understanding on the mechanism via which
environmental expo...

## Key facts

- **NIH application ID:** 10459187
- **Project number:** 5U01OH012271-02
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** DAVID J PREZANT
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $488,632
- **Award type:** 5
- **Project period:** 2021-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10459187

## Citation

> US National Institutes of Health, RePORTER application 10459187, EARLY DETECTION OF CLONAL HEMATOPOIESIS AND LEUKEMIA ASSOCIATED MUTATIONS IN WTC EXPOSED FIREFIGHTERS AFTER THE 9/11 ATTACKS (5U01OH012271-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10459187. Licensed CC0.

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