Dr. Miller on the Characteristics of Clonal Hematopoiesis

Peter G. Miller, MD, PhD, physician, Dana-Farber Cancer Institute, instructor in medicine, Harvard Medical School, discusses the characteristics of clonal hematopoiesis.

With age, cells acquire mutations that mostly do not affect cell growth, Miller says. However, some mutations can affect growth and, eventually, lead to cancer. For example, a colon polyp can develop with some mutations, but with additional genetic events, individuals can develop colon dysplasia or cancer, Miller says.

A similar scenario occurs in the hematopoietic system in which multiple or specific genetic events can lead to the development of myeloid neoplasia, including myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML). In the past decade, research has emerged suggesting that a significant proportion of healthy individuals have clonal hematopoiesis, meaning that they harbor blood abnormalities in a clonal population that increase their risk of developing MDS or AML, Miller says.

In addition to the increased risk of hematologic malignancies, these individuals are at a greater risk of developing and dying from ischemic cardiovascular events, such as myocardial infarctions and stroke, irrespective of other known risk factors, such as cholesterol level, Miller concludes.