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. Author manuscript; available in PMC: 2019 Aug 1.
Published in final edited form as: Hematol Oncol Clin North Am. 2018 May 1;32(4):643–655. doi: 10.1016/j.hoc.2018.03.005

Figure 2. Clonal hematopoiesis in inherited bone marrow failure and MDS/AML predisposition syndromes.

Figure 2

Bone marrow failure syndromes are associated with dysfunctional hematopoiesis that may drive a strong selective pressure that favors mutated hematopoietic stem and progenitor cells with enhanced fitness. While some mutations cause leukemic transformation (red circles), others may enable clonal expansion due to functional complementation of disease specific cellular defects (green circles). The latter may involve biological pathways that are distinct from leukemic transformation and not associated with elevated risk of progression to MDS or AML.