Steatotic liver disease in the context of hematological malignancies and anti-neoplastic chemotherapy

Metabolism. 2024 Nov:160:156000. doi: 10.1016/j.metabol.2024.156000. Epub 2024 Aug 12.

Abstract

The rising prevalence of obesity-related illnesses, such as metabolic steatotic liver disease (MASLD), represents a significant global public health concern. This disease affects approximately 30 % of the adult population and is the result of metabolic abnormalities rather than alcohol consumption. Additionally, MASLD is associated with an increased risk of cardiovascular disease (CVD), chronic liver disease, and a variety of cancers, particularly gastrointestinal cancers. Clonal hematopoiesis (CH) is a biological state characterized by the expansion of a population of blood cells derived from a single mutated hematopoietic stem cell. The presence of CH in the absence of a diagnosed blood disorder or cytopenia is known as clonal hematopoiesis of indeterminate potential (CHIP), which itself increases the risk of hematological malignancies and CVD. Steatotic liver disease may also complicate the clinical course of cancer patients receiving antineoplastic agents, a condition referred to as chemotherapy induced steatohepatitis (CASH). This review will present an outline of the various aspects of MASLD, including complications. Furthermore, it will summarize the existing knowledge on the emerging association between CHIP and MASLD and present the available data on patient cases with concurrent MASLD and hematological neoplasms. Finally, it will provide a brief overview of the chemotherapeutic drugs associated with CASH, the underlying pathophysiologic mechanisms and their clinical implications.

Keywords: Chemotherapy induced steatohepatitis (CASH); Chronic neutrophilic leukemia; Clonal hematopoiesis of indeterminate potential (CHIP); Hematological malignancies; Leukemia; Metabolic dysfunction-associated steatohepatitis (MASH); Metabolic steatotic liver disease (MASLD); Mucosa-associated lymphoid tissue (MALT) lymphoma; Multiple myeloma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / therapeutic use
  • Clonal Hematopoiesis
  • Fatty Liver* / chemically induced
  • Fatty Liver* / pathology
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / drug therapy
  • Humans

Substances

  • Antineoplastic Agents