A major new British study has identified the impact of chemotherapy on healthy blood, identifying mutations linked to some drugs.
The Cambridge-based researchers report that many, but not all, chemotherapy agents cause mutations and premature ageing in healthy blood.
The findings, reported in Nature Genetics, come from a study of the blood cell genomes of 23 cancer patients who had received chemotherapy. The patients, mostly treated in Cambridge, had been exposed to 21 different drugs from all the main classes of chemotherapy for blood cancers and for solid cancers. The findings were compared with genetic data from nine healthy people.
The researchers said the findings should help optimise treatment plans for patients, allowing doctors to consider alternative treatments when necessary.
Researcher Dr Jyoti Nangalia, a haematologist at Cambridge University Hospitals, said: “The effects of chemotherapy we see here – increasing numbers of mutations and premature ageing of healthy blood – reasonably contribute to the heightened risk of additional cancers and the patient’s ability to tolerate further treatments in the future.
“Given that for many cancers, chemotherapy drugs can be switched with other agents to achieve similar results, we hope such genomic data will guide the optimisation of future treatment plans to deliver effective chemotherapies with much fewer damaging side effects for patients.”
Fellow researcher Professor Sir Mike Stratton, of the Wellcome Sanger Institute, said: “I believe that the results of this study hold implications for the way that chemotherapies are used to treat cancer patients. We are constantly on the lookout for better ways of giving therapy and minimising the side effects of toxic, systemic treatments. I’m hopeful that the genomic information from this and future studies will guide choices of chemotherapies, and their adoption in clinical practice.”
Lead researcher Dr Emily Mitchell said: “This study lays the groundwork for future research into the effects of chemotherapy on many other normal tissues, including multiple tissue sampling pre and post treatment, across a range of chemotherapies in a larger group of patients. This comprehensive view would reveal the full range of effects of different chemotherapies and help us to optimise patient health in the long term.”
Source:
Mitchell E, Pham MH, Clay A, Sanghvi R, Williams N, Pietsch S, Hsu JI, Jung H, Vedi A, Moody S, Wang J, Leonganmornlert D, Spencer Chapman M, Dunstone E, Santarsieri A, Cagan A, Machado HE, Baxter EJ, Follows G, Hodson DJ, McDermott U, Doherty GJ, Martincorena I, Humphreys L, Mahbubani K, Saeb Parsy K, Takahashi K, Goodell MA, Kent D, Laurenti E, Campbell PJ, Rahbari R, Nangalia J, Stratton MR. (2025) “The long-term effects of chemotherapy on normal blood cells.” Nature Genetics, 1 July 2025, doi: 10.1038/s41588-025-02234-x.
Link: https://www.nature.com/articles/s41588-025-02234-x
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