International Journal of Contemporary Research In Multidisciplinary, 2026;5(3):1057-1071
Clonal Hematopoiesis: Biological Mechanisms, Clinical Implications, and Therapeutic Opportunities
Author Name: Himanshu Saini;
Abstract
Clonal Hematopoiesis (CH) is an age-associated phenomenon characterized by the expansion of hematopoietic stem and progenitor cells (HSPCs) harbouring somatic mutations. Initially considered a benign consequence of aging, CH—particularly clonal hematopoiesis of indeterminate potential (CHIP)—has emerged as a significant risk factor for hematologic malignancies, cardiovascular disease, and increased mortality. Advances in next-generation sequencing (NGS) technologies have enabled the detection of low-frequency somatic mutations, fundamentally reshaping our understanding of hematopoietic aging and disease evolution. The most commonly implicated genes include DNMT3A, TET2, and ASXL1, which are involved in epigenetic regulation. Mutations in these genes confer a selective advantage, leading to clonal expansion under conditions of aging, inflammation, and environmental stress. This review discusses the biological basis of CH, its epidemiology, and its role in disease pathogenesis. We further examine diagnostic approaches, clinical implications, and emerging therapeutic strategies, including anti-inflammatory interventions and precision medicine approaches. Finally, we highlight future directions necessary to integrate CH into routine clinical practice.
Keywords
Clonal hematopoiesis; CHIP; hematopoietic stem cells; ageing; leukaemia; inflammation; cardiovascular disease; epigenetics.