As people age, their blood-forming stem cells can acquire small genetic changes that affect genes associated with blood cancer. This is called clonal hematopoiesis (CH).

There are two main types of CH:

• Clonal hematopoiesis of indeterminate potential (CHIP): Genetic changes in blood-forming stem cells without associated changes in blood counts or evidence of blood cancer.
• Clonal cytopenias of undetermined significance (CCUS): Genetic changes in blood-forming stem cells along with otherwise unexplained low blood counts, such as:
  •   Low red blood cells (anemia)
  •   Low platelets (thrombocytopenia)
  •   Low neutrophils (neutropenia)

Studies show that CH is common in older adults, affecting over 10% of people age 65 or older.

Many people with CH do not experience symptoms or immediate health problems when it is first discovered. However, certain forms of CH are associated with an increased risk of developing blood cancers such as myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), or acute myeloid leukemia (AML).

CH may also be associated with health risks outside of the blood system, including cardiovascular disease and inflammatory conditions. These risks can be relevant even when blood counts are normal, as in CHIP.

Clinical services

Currently, there are no standard guidelines for managing clonal hematopoiesis. The goals of the Clonal Hematopoiesis and Leukemia Prevention Clinic are to:

• Identify individuals at higher risk for developing blood cancers and offer personalized monitoring and prevention strategies. Risk factors include age, blood counts, clone size, number of mutations and mutation type.
• Help patients manage related health risks, especially heart and autoinflammatory diseases.
• Learn more about how CH develops and why some cases progress to disease.

Who should come to the clinic

Routine screening for clonal hematopoiesis is not recommended for people who are otherwise healthy and do not have an identified blood-related mutation or unexplained abnormalities in their blood counts.

You may benefit from an evaluation at the Clonal Hematopoiesis and Leukemia Prevention Clinic if genetic testing has identified a blood-related mutation or chromosome abnormality, or if you have persistently abnormal blood counts that do not have a clear cause.

An evaluation may also be appropriate for some people with a history of chemotherapy or radiation treatment, cardiovascular disease, or inflammatory or autoimmune conditions.

Clonal hematopoiesis involves genetic changes that develop over time and are usually not inherited. If you are concerned about an inherited risk of leukemia or other blood cancers, visit the Hereditary Leukemia Clinic.

Making an appointment

Both physician referrals and self-referrals are welcome. Visit our appointments page.

Because clonal hematopoiesis findings can be complex, self-referrals are reviewed by our clinical team before an appointment is scheduled. This helps ensure that patients are matched with the clinic or specialist best suited to their individual needs.

• Current Patients: 713-792-8760
• New Patients: 855-258-3583
• Toll Free (all patients): 85-Leukemia
   

Clinical trials at UT MD Anderson

Clinical trials play an important role in improving treatment for at-risk CH patients and helping researchers better understand the disease.

UT MD Anderson is one of the leading centers studying CH, with physicians and scientists actively conducting clinical trials and publishing research to improve treatment approaches.

Participating in a clinical trial may give some individuals access to promising new therapies that are not yet widely available. Your care team can help determine whether a clinical trial may be appropriate for your situation.

To see currently available studies, visit the UT MD Anderson clinical trials search page.