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. 2023 Jan 4;13(1):5. doi: 10.1038/s41408-022-00773-8

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — During lymphocyte development, HSC’s follow a multi-step differentiation pathway which includes the rearrangement of BCR or TCR genes for B cells and T cells respectively. Receptor rearrangement defines distinct stages of lymphocyte development with the rearrangement of the immunoglobulin heavy chain or TCRβ defining the transition from pro-B/T to pre-B/T cells and the subsequent rearrangement of the immunoglobulin light chain or TCRα chain occurring during the transition from pre-B/T to mature B/T cells. Stochastic rearrangement of lymphocyte receptor genes in each developing cell produces a diverse repertoire of B and T cells. (Upper) CH mutations which occur in the HSC, defined here as central lymphoid clonal hematopoiesis, are carried forth in all progeny cells which then undergo receptor rearrangement to form a receptor-diverse CH clone. (Lower) CH mutations occurring in mature lymphocytes which have already completed receptor rearrangement, defined here as peripheral lymphoid clonal hematopoiesis, will expand and form a receptor-homogenous CH clone.