Fig. 1. M-CH and L-CH biased mutations drive distinct health outcomes.

Mutations acquired in hematopoietic stem cells can provide a selective advantage, leading to the formation and expansion of an HSC clone. Often these mutations bias the production of progeny cells towards either myeloid or lymphoid lineages of cells and have distinct consequences for each lineage. In myeloid biased clonal hematopoiesis (left), somatic mutations are associated with an increased risk of myeloid malignancy, cardiovascular disease, and all-cause mortality. In lymphoid biased clonal hematopoiesis (right), somatic mutations are associated with lymphoid malignancy and late-onset forms of autoimmunity and immune deficiency.