Figure 1. Model of leukemic transformation in SCN.
Aging related mutations that occur during HSC replication result in the production of a genetically heterogeneous pool of HSCs. In SCN, the persistently high level of G-CSF results in the selection of HSCs that carrying truncations mutations of CSF3R (encoding the G-CSF receptor). Additional mutations, most commonly of RUNX1, are required for transformation to MDS/AML.