[Clonal hematopoiesis: a risk factor for leukemia and cardiovascular disease?]

Ned Tijdschr Geneeskd. 2020 Nov 5:164:D5205.
[Article in Dutch]

Abstract

Upon ageing, hematopoietic stem or progenitor cells harboring acquired leukemia-associated mutations may expand clonally and become detectable in peripheral blood. So-called clonal hematopoiesis may be detected in 5-55% of (otherwise healthy) individuals aged ≥ 70 years. Clonal hematopoiesis is associated with a higher risk of developing hematological neoplasms, although most individuals never develop malignant disease. Surprisingly, clonal hematopoiesis is also recognized as a new cardiovascular risk factor. Specific patient categories may be at higher risk for the consequences of clonal hematopoiesis. For future risk stratification, there is a need to distinguish high-risk clonal hematopoiesis from 'physiological' ageing processes. In this article we summarize current knowledge on clonal hematopoiesis and its clinical implications. Given the widespread application of next-generation sequencing in routine diagnostics, multidisciplinary recommendations for clinical management of individuals with detected clonal hematopoiesis should be developed.

MeSH terms

  • Aged
  • Aging / genetics*
  • Cardiovascular Diseases / genetics*
  • Clonal Hematopoiesis / genetics*
  • Female
  • Heart Disease Risk Factors
  • Hematologic Neoplasms / genetics
  • Humans
  • Leukemia / genetics*
  • Male
  • Mutation
  • Risk Assessment