Clonal hematopoiesis in clinical practice: walking a tightrope

Abstract

The understanding of clonal hematopoiesis (CH) and its features is rapidly evolving in step with the spread of sequencing techniques. Indeed, CH detection is now an emerging aspect in clinical practice. The awareness of CH intersects with consolidated diagnostic paths, thus exposing ‘grey zone’ circumstances under the magnifying lens of clinicians. The interpretation of genomic data poses, in some cases, a true clinical challenge, sometimes further complicating the route to diagnosis. The line separating different entities is thin. The present work aims to review some of these challenging situations to help clinicians keep their balance along this tightrope.

Keywords:

• Clonal hematopoiesis
• cytopenia
• oligomonocytic-CMML
• splenomegaly
• double-mutated MPN
• MRD

Authors’ contributions

Conceptualization: F.T., C.C., F.A.; writing–original draft preparation: F.T., C.C., F.A.; writing–review and editing: F.T., C.C., L.A., A.Z., N.C., G.T., G.S., P.M., F.A.; supervision: F.A. All authors have read and agreed to the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by “Associazione Italiana contro le Leucemie (AIL)-BARI”.