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IBC 2025 | How has our understanding of clonal hematopoiesis advanced in recent years?
George Vassiliou, MBBS, PhD, The University of Cambridge, Cambridge, UK, highlights advances that have been made in the understanding of clonal hematopoiesis (CH), stating that it is a long-term process where a single cell grows and expands over years. Prof. Vassiliou explains that CH is now recognized as a common condition associated with various non-hematological diseases, and its understanding has led to the development of targeted treatments and preventive actions. This interview took place at the 3rd Intercepting Blood Cancers (IBC) Workshop held in Nice, France.
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Transcript
We’ve learned a lot about clonal hematopoiesis. Remember, the phenomenon was fully captured in terms of its genetic background, let’s say, in 2014-2015. So we’ve had about 10 years of learning. We’ve learned that clonal hematopoiesis is a very long, let’s say, phenomenon, a single cell grows steadily and slowly over years. We’ve learned that the different gene mutations can drive the expansion slowly or more fast...
We’ve learned a lot about clonal hematopoiesis. Remember, the phenomenon was fully captured in terms of its genetic background, let’s say, in 2014-2015. So we’ve had about 10 years of learning. We’ve learned that clonal hematopoiesis is a very long, let’s say, phenomenon, a single cell grows steadily and slowly over years. We’ve learned that the different gene mutations can drive the expansion slowly or more fast. We’ve learned that aging can change the rate at which clones expand. In fact, certain clones do not expand at all when you’re young. Other clones seem to not expand when you’re old. But we’ve also learned that certain mutations have a higher risk of progressing to malignancy and others don’t. We’ve learned that the clone size increases the risk of malignancy and primarily we have learned that this phenomenon is really common and we have ways of identifying those who are high risk and low risk. Why do I say primarily because we needed this in order to start targeting treatments, interventions, and preventive action to those individuals. And the other big development in clonal hematopoiesis is its association with a large number of non-hematological diseases, cardiovascular disease, lung disease, kidney disease, bone disease, etc. And clonal hematopoiesis has now moved into the realm of many medical specialties. You know, as a clonal hematopoiesis expert, let’s call myself an expert if I may, but as someone who works very intensely with clonal hematopoiesis, I get contacted by all sorts of specialties trying to understand what clonal hematopoiesis does in their specialty. So there is a whole lot of new information. I mean, there’s still a lot to learn, which is great news, because we love doing research, we love understanding, we love treating, we love preventing. But we have learned a lot, and I think we’ve moved from somewhere where we didn’t know should we be treating, should we be interfering, to somewhere where we are poised to do that. So it’s quite exciting, and I look forward to the next few years.
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