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Ned Tijdschr Geneeskd ; 1642020 11 05.
Article in Dutch | MEDLINE | ID: mdl-33331716

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.


Subject(s)
Aging/genetics , Cardiovascular Diseases/genetics , Clonal Hematopoiesis/genetics , Leukemia/genetics , Aged , Female , Heart Disease Risk Factors , Hematologic Neoplasms/genetics , Humans , Male , Mutation , Risk Assessment
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