Clinical decisions in clonal hematopoiesis: a contemporary review for clinicians

Area of Science:

• Hematology
• Genetics
• Internal Medicine

Background:

• Clonal hematopoiesis (CH) is increasingly recognized as a key factor in age-associated diseases, including hematologic malignancies and cardiovascular conditions.
• CH has significant implications for cancer therapy and autoimmune disorders, highlighting its broad clinical relevance.
• Translating CH research into clinical practice is crucial for advancing patient care.

Purpose of the Study:

• To synthesize evidence supporting the integration of CH testing and monitoring into clinical practice.
• To present a systematic framework for establishing and operating dedicated CH programs.
• To provide practical insights and recommendations for developing comprehensive CH management programs.

Main Methods:

• Systematic review of current evidence on CH.
• Analysis of risk stratification, surveillance, and intervention strategies for CH-associated conditions.
• Incorporation of institutional experience and best practices for CH program development.

Main Results:

• Evidence supports the integration of CH testing and monitoring into clinical practice.
• A systematic framework for CH program establishment and operation is proposed.
• Key considerations for clinical implementation include genetic counseling, interdisciplinary coordination, and patient education.

Conclusions:

• Integrating CH testing and monitoring into clinical practice is essential for managing age-associated diseases.
• A structured approach, including risk stratification and surveillance, can optimize CH management.
• Bridging the gap between molecular discoveries and clinical care delivery is achievable through comprehensive CH programs.