Fig. 1.

The spectrum of clonal hematopoiesis from pre-neoplastic states to myeloid neoplasms. Pre-neoplastic states: clonal hematopoiesis of indeterminate potential (CHIP) is defined by the presence of somatic mutation(s) with variant allele frequency ≥ 2% without cytopenia; clonal cytopenias of undetermined significance (CCUS) has both a somatic variant and cytopenias. Myeloid neoplasms: myelodysplastic syndrome (MDS) is characterized by dysplasia (abnormal cellular morphology) on a bone marrow exam and peripheral cytopenia; acute myeloid leukemia (AML) further involves the excessive proliferation of blasts (immature myeloid cells) with somatic mutations blocking normal hematopoiesis.