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Stepwise development from polyclonal hematopoiesis (normal, no evidence of somatic mutations) to clonal hematopoiesis of indeterminate potential (CHIP), myelodysplastic syndromes (MDS), and acute myeloid leukemia (AML). ICUS, idiopathic cytopenia of indeterminate significance. The mutated genes (DNMT3A, ASXL1, TP53) are shown as examples; other genes may be affected, and in a different order.
