Agent skill

chip-clonal-hematopoiesis-agent

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Install this agent skill to your Project

npx add-skill https://github.com/FreedomIntelligence/OpenClaw-Medical-Skills/tree/main/skills/chip-clonal-hematopoiesis-agent

SKILL.md


name: 'chip-clonal-hematopoiesis-agent' description: 'AI-powered clonal hematopoiesis of indeterminate potential (CHIP) detection, risk stratification, and cardiovascular/malignancy risk prediction using genomic and clinical data.' measurable_outcome: Execute skill workflow successfully with valid output within 15 minutes. allowed-tools:

  • read_file
  • run_shell_command

CHIP Clonal Hematopoiesis Agent

The CHIP Clonal Hematopoiesis Agent provides comprehensive detection and risk stratification of clonal hematopoiesis of indeterminate potential (CHIP). It identifies clonal mutations in blood cells, assesses risk of progression to myeloid malignancy, and predicts cardiovascular disease risk, integrating with the CHIC machine learning framework for CBC-based screening.

When to Use This Skill

  • When detecting CHIP mutations from blood sequencing data.
  • For stratifying risk of progression to MDS/AML.
  • To assess CHIP-associated cardiovascular disease risk.
  • When filtering CHIP variants from tumor liquid biopsy.
  • For population-level CHIP screening and research.

Core Capabilities

  1. CHIP Detection: Identify clonal mutations with VAF >2%.

  2. Risk Stratification: Predict myeloid malignancy progression risk.

  3. CVD Risk Assessment: Estimate cardiovascular disease risk.

  4. CCUS Classification: Distinguish CHIP from CCUS/MDS.

  5. Clone Size Tracking: Monitor clonal evolution over time.

  6. ctDNA Filtering: Remove CHIP from tumor ctDNA analysis.

CHIP-Associated Genes

Gene Frequency Malignancy Risk CVD Risk
DNMT3A 50% Moderate Elevated
TET2 20% Moderate Elevated (inflammatory)
ASXL1 10% High Moderate
JAK2 5% High (MPN) Elevated (thrombosis)
TP53 5% Very High Low
SF3B1 3% Moderate-High Low
SRSF2 3% High Low
PPM1D 2% Moderate Therapy-related
CBL 2% High Moderate
IDH1/2 2% Moderate-High Low

Risk Categories

Category Criteria Annual AML Risk
Low-Risk CHIP DNMT3A/TET2, VAF <10% <0.5%
Intermediate CHIP DNMT3A/TET2, VAF >10% 0.5-1%
High-Risk CHIP ASXL1, TP53, splicing 1-3%
CCUS CHIP + cytopenia 3-10%
Pre-MDS High-risk mutations + dysplasia >10%

Workflow

  1. Input: Blood sequencing (WES/panel), CBC data, clinical history.

  2. Variant Detection: Call somatic variants with VAF filtering.

  3. CHIP Classification: Identify CHIP-defining mutations.

  4. Risk Scoring: Calculate malignancy and CVD risk scores.

  5. Longitudinal Analysis: Track clone dynamics if serial samples.

  6. Clinical Integration: Generate management recommendations.

  7. Output: CHIP status, risk scores, monitoring plan.

Example Usage

User: "Analyze this patient's blood sequencing for CHIP and calculate their risk of progression and cardiovascular events."

Agent Action:

bash
python3 Skills/Hematology/CHIP_Clonal_Hematopoiesis_Agent/chip_analysis.py \
    --variants blood_variants.vcf \
    --cbc_data patient_cbc.csv \
    --clinical_data patient_demographics.json \
    --vaf_threshold 0.02 \
    --age 65 \
    --calculate_cvd_risk true \
    --output chip_analysis/

CHRS Risk Score (Clonal Hematopoiesis Risk Score)

Factor Points Notes
High-risk mutation +2 SRSF2, SF3B1, ZRSR2, IDH1/2, FLT3, RUNX1, JAK2
Single DNMT3A mutation -1 Lower risk
≥2 mutations +1 Increased burden
VAF ≥20% +1 Large clone
CCUS (vs CHIP) +2 Cytopenia present
RDW ≥15% +1 Blood count abnormality
MCV ≥100 fL +1 Macrocytosis
Age ≥65 +1 Age-related risk

Output Components

Output Description Format
CHIP Status Present/Absent, genes involved .json
Mutation Details VAF, gene, protein change .csv
Malignancy Risk 5-year AML/MDS probability .json
CVD Risk Cardiovascular risk score .json
CHRS Score Clonal hematopoiesis risk score .json
Recommendations Clinical management .md
Monitoring Plan Follow-up schedule .json

AI/ML Components

CHIC Framework:

  • Machine learning from CBC indices
  • Identifies high-risk CHIP without sequencing
  • Reduces "number needed to sequence"

Risk Prediction:

  • Cox proportional hazards for progression
  • Random survival forests
  • Deep learning survival models

CVD Risk Integration:

  • Framingham score adjustment
  • CHIP-specific hazard ratios
  • Inflammatory biomarker integration

Cardiovascular Risk

CHIP Gene CVD Hazard Ratio Mechanism
TET2 1.9 IL-6, inflammasome
DNMT3A 1.7 Inflammation
JAK2 2.6 Thrombosis, platelet activation
ASXL1 2.0 Inflammation
Overall CHIP 1.5-2.0 Multiple pathways

Clinical Management Guidelines

CHIP Category Monitoring Intervention
Low-risk Annual CBC None
Intermediate CBC q6 months CVD optimization
High-risk CBC q3-6 months, consider BMB Hematology referral
CCUS BMB, q3 month CBC Active surveillance

Prerequisites

  • Python 3.10+
  • Variant callers (Mutect2, VarScan)
  • ANNOVAR/VEP for annotation
  • lifelines, scikit-survival
  • CHIC model weights

Related Skills

  • MPN_Progression_Monitor_Agent - MPN monitoring
  • CHIC_ML_Framework_Agent - CBC-based screening
  • MDS_Classification_Agent - MDS diagnosis
  • Bone_Marrow_AI_Agent - Morphology analysis

CHIP vs ctDNA Filtering

Feature CHIP Tumor ctDNA
VAF Stability Stable over time Changes with disease
Genes DNMT3A, TET2, ASXL1 Tumor drivers
Age Association Increases with age Independent
Multiple Samples Consistent Variable

Special Considerations

  1. VAF Threshold: Use 2% for CHIP definition
  2. Germline Filtering: Exclude germline variants
  3. Age Context: Prevalence increases with age
  4. Therapy History: Consider treatment-related clones
  5. Serial Monitoring: Track clone dynamics

Population Prevalence

Age Group CHIP Prevalence High-Risk CHIP
40-49 ~2% <0.5%
50-59 ~5% ~1%
60-69 ~10% ~2%
70-79 ~15% ~4%
80+ ~20% ~5%

Therapeutic Implications

Scenario CHIP Impact Consideration
CAR-T Therapy May affect outcomes Monitor clones
Stem Cell Transplant Donor CHIP matters Screen donors
Chemotherapy May expand clones Monitor post-treatment
Cardiovascular Increased risk Aggressive prevention

Author

AI Group - Biomedical AI Platform

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