Donor cell leukemia arising from clonal hematopoiesis after bone marrow transplantation

Alterations in genes encoding epigenetic regulators are common in myeloid malignancies, and several recent studies have demonstrated that these mutations are present at high frequencies within peripheral blood cells in approximately 10% of individuals over 60 years of age. Although the presence of these mutations carries an increased risk of subsequent hematologic malignancies, the vast majority of individuals do not progress clinically and the natural history of clonal hematopoiesis is unclear.1-3 Thus, the term Clonal Hematopoiesis of Indeterminate Potential (CHIP) was proposed.4