Clonal Hematopoiesis from a Diagnostic Perspective: 10 Years of CHIP

• Published in: Molecular diagnosis & therapy 2024-11, Vol.28 (6), p.665-668
• Main Authors: Kjær, Lasse, Skov, Vibe, Larsen, Morten Kranker, Kristiansen, Marie Hvelplund, Wienecke, Troels, Cordua, Sabrina, Ellervik, Christina, Langabeer, Stephen E, Hasselbalch, Hans Carl
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Cardiovascular diseases; Hematopoiesis; Hematopoietic stem cells; Hemopoiesis; Inflammation; Malignancy; Mortality; Mutation; Myeloid cells; Point mutation; Positive selection; Preventive medicine
• ISSN: 1177-1062; 1179-2000
• DOI: 10.1007/s40291-02400737-7

Skov et al discuss clonal hematopoiesis. Clonal hematopoiesis of indeterminate potential (CHIP), defined by expansion of clones containing myeloid-associated gene mutations in the absence of a hematological malignancy, was recently implemented in the World Health Organization as a precursor myeloid disease state. This has signaled the arrival of a new era, where clinicians need to decode the significance of pre-malignant clones and implement preventive medicine in a cross-specialty setting managing inflammation, cardiovascular disease, and malignancy. Clonal expansion driven by positive selection through cell intrinsic and-or extrinsic factors such as activating mutations and inflammation is a hallmark of aging in several tissues, but where clonal expansions in solid tissues are usually small and physically confined, expansions of hematopoietic cells, which can alter inflammatory and immune functions, are extremely mobile and can affect virtually all organs. The CHIP mutations are restricted to a narrow selection of genes, and the subtype influences the health impact.