Clonal hematopoiesis in human aging and disease

Science. 2019 Nov 1;366(6465):eaan4673. doi: 10.1126/science.aan4673.


As people age, their tissues accumulate an increasing number of somatic mutations. Although most of these mutations are of little or no functional consequence, a mutation may arise that confers a fitness advantage on a cell. When this process happens in the hematopoietic system, a substantial proportion of circulating blood cells may derive from a single mutated stem cell. This outgrowth, called "clonal hematopoiesis," is highly prevalent in the elderly population. Here we discuss recent advances in our knowledge of clonal hematopoiesis, its relationship to malignancies, its link to nonmalignant diseases of aging, and its potential impact on immune function. Clonal hematopoiesis provides a glimpse into the process of mutation and selection that likely occurs in all somatic tissues.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aging*
  • Animals
  • Cardiovascular Diseases / genetics*
  • Cardiovascular Diseases / physiopathology
  • Clonal Evolution
  • Clone Cells
  • Hematologic Neoplasms / genetics*
  • Hematologic Neoplasms / physiopathology
  • Hematopoiesis*
  • Hematopoietic Stem Cells / cytology
  • Hematopoietic Stem Cells / physiology*
  • Humans
  • Mutation*
  • Precancerous Conditions / genetics*
  • Precancerous Conditions / physiopathology