CHIP clinics: a practical overview of structure and function

Modern knowledge about the principles of clonal hematopoiesis of indeterminate potential (CHIP) has paved way for numerous clinical efforts aimed at managing this pre-malignant condition. The emergence of various CHIP clinics across the globe attests to collaborative attempts to formalize clinical management of CHIP and its entities. However, translational science in this field is limited to date, partly due to nascent therapeutic concepts with limited understanding of natural history and longitudinal follow up. Here, we explore the structure and function of existing CHIP clinics and propose a working model to materialize future CHIP clinics at academic and community health care systems. We discuss the critical elements in conceptualizing and operationalizing CHIP clinic workflows, including pinpointing unmet clinical needs, prospective and retrospective identification of patients with CHIP, and recruitment of key CHIP clinic personnel toward creation of an effective multidisciplinary team. We underscore the clinical utility of CHIP clinics with regard to value creation in preventive hematology, real-world risk assessment using evidence-based models, provision of clinical trial enrollment opportunities, establishment of curated research registries and tissue biorepositories, and development of community outreach efforts. Finally, we shed light onto prospects of continued multi-center participation in collaborative science related to emerging therapeutic options in CHIP. These concepts may have a favorable impact on previvorship in hematology in the coming years.