Englander Institute for Precision Medicine

Clonal Hematopoiesis and Premalignant Diseases.

TitleClonal Hematopoiesis and Premalignant Diseases.
Publication TypeJournal Article
Year of Publication2020
AuthorsKaner J, Desai P, Mencia-Trinchant N, Guzman ML, Roboz GJ, Hassane DC
JournalCold Spring Harb Perspect Med
Volume10
Issue4
Date Published2020 Apr 01
ISSN2157-1422
KeywordsAnimals, Clonal Hematopoiesis, Hematologic Neoplasms, Hematopoietic Stem Cells, Humans, Leukemia, Mutation, Neoplasm Proteins, Precancerous Conditions
Abstract

Clonal hematopoiesis (CH) arises when mutations in the hematopoietic system confer a fitness advantage to specific clones, thereby favoring their disproportionate growth. The presence of CH increases with age and environmental exposures such as cytotoxic chemotherapy or radiotherapy. The most frequent mutations occur in epigenetic regulators, such as , , and , leading to dysregulation of tumor suppressor function, pathogen response, and inflammation. These dysregulated processes elevate risk of overall mortality, cardiovascular disease, and eventual hematologic malignancy (HM). CH is likely acting as an initiating event leading to HM when followed by cooperating mutations. However, further evidence suggests that CH exerts a bystander influence through its pro-inflammatory properties. Delineating the mechanisms that lead to the onset and expansion of CH as well as its contribution to risk of HM is crucial to defining a management and intervention strategy. In this review, we discuss the potential causes, consequences, technical considerations, and possible management strategies for CH in the context of HMs and pre-HMs.

DOI10.1101/cshperspect.a035675
Alternate JournalCold Spring Harb Perspect Med
PubMed ID31615870
PubMed Central IDPMC7117948

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