Connect Sign InHematopathology Expert Series
The Broad-Ranging Impact of Clonal Hematopoiesis: From Diagnostic Considerations to Clinical Implications
Premalignant clonal hematopoiesis refers to a heterogeneous group of conditions, including clonal hematopoiesis of indeterminate potential (CHIP) and clonal cytopenia of undetermined significance (CCUS). CCUS is defined by expansion of a population of hematopoietic cells derived from a single clone, as demonstrated by the detection of myeloid neoplasm-associated somatic mutation or cytogenetic aberration (i.e., clonal hematopoiesis) in association with sustained cytopenia otherwise clinically unexplained and absence of dysplasia. CHIP is a closely related entity defined by the presence of clonal hematopoiesis in the absence of cytopenia. In both conditions, diagnostic criteria of myelodysplastic or other hematologic neoplasm are unmet. The natural history and risk of progression from clonal hematopoiesis to overt malignancy is augmented by mutational dynamics. Substantial data links CHIP to increased all-cause mortality primarily attributable to cardiovascular disease such as myocardial infarction, ischemic stroke, and venous thrombosis. The principal feature underlying these nonhematologic disease associations is a proinflammatory state. Clinical management of patients with clonal hematopoiesis is an area of active investigation.
Dr. Jay L. Patel is vice president of PharmaDx and Clinical Trials at ARUP Laboratories and professor of Pathology at the University of Utah School of Medicine. Dr. Patel obtained his medical degree from the University of Arizona. Following medical school, he completed an anatomic and clinical pathology residency at the University of Utah and a hematopathology fellowship at Stanford University. Dr. Patel is board certified in anatomic and clinical pathology and hematopathology. He then received a master’s degree in business administration from the University of Utah. Dr. Patel’s clinical and research interests include the application of massively parallel sequencing technologies in hematological malignancies.
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