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. 2017 Jan 3;31(3):534–542. doi: 10.1038/leu.2016.364

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Copyright © 2017 The Author(s)

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Hematopoiesis: Normal elderly individual±evolution to sAML. Normal elderly individuals can develop clonal hemtopoiesis marked by a mutation in their early hematopoietic stem cells (HSC). Some of these individuals will develop myelodysplastic syndrome (MDS); and with the acquisition of a Driver mutation, they can develop secondary AML (sAML). These patients may go into complete morphologic remission but often retain their preleukemic clone. With relapse, they can either retain the original Driver mutation or acquire a new Driver mutation. Dotted line suggests that some normal elderly individuals with clonal hematopoiesis may develop MDS and sAML.