意义未明的克隆性造血：血液系统恶性肿瘤的根本原因及滋生土壤。

Clonal hematopoiesis of indeterminate potential: the root cause of, and fertile ground for, hematological malignancies.

作者信息

Zhuang Qiqi, Jin Shengjie, Wang Wei, Wang Yan, Tong Hongyan, Liu Zuyun, Sun Jie

机构信息

Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of Hematologic Malignancies, Diagnosis, and Treatment, Hangzhou, Zhejiang, China.

Key Laboratory of Hematologic Malignancies, Diagnosis, and Treatment, Hangzhou, Zhejiang, China; Department of Biochemistry and Molecular Biology, Monash University, Clayton, Melbourne, Victoria, Australia.

出版信息

Trends Mol Med. 2025 Mar;31(3):252-264. doi: 10.1016/j.molmed.2024.10.005. Epub 2024 Oct 25.

DOI:10.1016/j.molmed.2024.10.005

PMID:39490273

Abstract

Clonal hematopoiesis (CH) of indeterminate potential (CHIP), characterized by propagation of blood cell clones carrying somatic mutations in specific driver genes, is increasingly recognized as a critical factor in the development of hematological malignancies. This phenomenon, which often emerges with age, underscores the complex interplay between genetic predisposition and environmental influences in cancer initiation and progression. Recent years have witnessed significant advances in our understanding of the link between CHIP and hematological diseases. In this review, we provide a comprehensive overview of the features of CHIP and explore its role in promoting tumorigenesis and influencing treatment outcomes for blood cancers. Finally, we summarize current available tools for risk stratification and discuss management strategies for patients with CHIP.

摘要

具有不确定潜能的克隆性造血（CHIP），其特征是携带特定驱动基因突变的血细胞克隆增殖，越来越被认为是血液系统恶性肿瘤发生发展的关键因素。这种现象通常随年龄出现，强调了遗传易感性与环境影响在癌症发生和发展过程中的复杂相互作用。近年来，我们对CHIP与血液系统疾病之间联系的理解取得了重大进展。在本综述中，我们全面概述了CHIP的特征，并探讨其在促进肿瘤发生和影响血癌治疗结果中的作用。最后，我们总结了当前可用的风险分层工具，并讨论了CHIP患者的管理策略。