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Clonal hematopoiesis in children with predisposing conditions
Enrico Attardi1, Seth J Corey2, Marcin W Wlodarski3
1Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN; Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy.
Seminars in Hematology
|February 4, 2024
Summary
Clonal hematopoiesis in young individuals (CHIPI) arises from various stressors, differing from age-related forms. Understanding CHIPI is key to identifying preleukemic states and preventing leukemia.
Area of Science:
- Hematology
- Genetics
- Oncology
Background:
- Clonal hematopoiesis in children and young adults, termed CHIPI, is distinct from age-related CHIP.
- Stressors like infections or genetic predispositions drive CHIPI, independent of typical aging processes.
Approach:
- This review synthesizes current research on stress-induced clonal hematopoiesis in individuals with germline predispositions.
- It differentiates CHIPI from age-related CHIP and explores its underlying mechanisms.
Key Points:
- CHIPI is driven by extrinsic (e.g., immunologic, genotoxic) or intrinsic (germline defects) stressors.
- Clonal advantage in CHIPI involves cellular adaptations for improved fitness despite intrinsic defects.
- CHIPI's impact is context-dependent, potentially counteracting or worsening underlying pathology.
Conclusions:
- Understanding CHIPI is crucial for defining preleukemic states in young individuals.
- Further research can inform risk assessment, surveillance, and prevention strategies for leukemic transformation.
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