Ziemann Frank, Metzeler Klaus Hans
Dtsch Med Wochenschr. 2023 Apr;148(8):441-450. doi: 10.1055/a-1873-4250. Epub 2023 Mar 29.
Clonal hematopoiesis of indeterminate potential (CHIP) refers to the outgrowth of blood cells from a hematopoietic stem cell (HSC) clone that acquired one or more somatic mutations, leading to a growth advantage compared to wild type HSCs. In the last years this age-associated phenomenon has been extensively studied, and several cohort studies found association between CH and age-related diseases, esp. leukaemia and cardiovascular disease. For patients with CH present with abnormal blood counts, the term 'clonal cytopenia of unknown significance' is used, which carries a higher risk for developing myeloid neoplasms. In this year, CHIP and CCUS have been included in the updated WHO classification of hematolymphoid tumours. We review the current understanding of the emergence of CHIP, diagnostics, association with other diseases, and potential therapeutic interventions.
意义未明的克隆性造血（CHIP）是指造血干细胞（HSC）克隆产生的血细胞生长，该克隆获得了一个或多个体细胞突变，与野生型造血干细胞相比具有生长优势。近年来，这种与年龄相关的现象得到了广泛研究，多项队列研究发现CH与年龄相关疾病，尤其是白血病和心血管疾病之间存在关联。对于存在血细胞计数异常的CH患者，使用“意义未明的克隆性血细胞减少症”这一术语，其发生髓系肿瘤的风险更高。今年，CHIP和意义未明的克隆性血细胞减少症已被纳入世界卫生组织（WHO）更新的血液淋巴系统肿瘤分类中。我们综述了目前对CHIP的发生、诊断、与其他疾病的关联以及潜在治疗干预措施的认识。
