Clonal hematopoiesis (CH) happens when a cell called a hematopoietic (HEE-muh-toh-poy-ET-ik ) stem cell starts making cells with the same genetic mutation (change). Hematopoietic stem cells can become different types of blood cells. These blood cells have a different genetic pattern than the rest of your blood cells. Clonal hematopoiesis is also known as clonal hematopoiesis of indeterminant potential (CHIP).
There are no warning signs of CH. Most people with CH never have any symptoms. Many people find out they have CH after genetic testing of their blood for other reasons.
CH can lead to blood cancers, especially myelodysplastic syndrome and acute myeloid leukemia. This is rare, and most people with CH never get blood cancer. Less than 1 out of every 100 people with CH get blood cancer each year.
People with CH also have a higher risk of cardiovascular problems, such as heart attacks. People with CH have about the same risk of having cardiovascular disease as people with diabetes.
Our CH clinic at Memorial Sloan Kettering Cancer Center (MSK) includes experts in leukemia and bone marrow transplants, as well as cardiologists. Our team monitors people with CH and tracks their risk for getting blood cancer. We recommend regular testing based on risk levels, with more frequent testing for those at high risk.
We offer clinical trials for CH to people who are eligible. These are research studies that look at new ways to treat CH or improve quality of life for those with CH.
1. What causes CH?
There is no single cause of CH, but some factors can increase your risk for CH, such as:
- age
- being male
- being white
- smoking
Radiation therapy and some types of chemotherapy may be linked to CH, but more research is needed.
2. Should I be tested for CH?
Routine testing for CH isn’t recommended. This is because:
- There aren’t currently any treatments for CH.
- Most people with CH have a low risk of getting a blood cancer.
- Doctors are still learning about the connection between cardiovascular disease and CH.
3. What should I do if I have CH?
If CH doesn’t become blood cancer, you won’t need treatment.
If you have CH, visit a primary care doctor or cardiologist (heart doctor) to keep your heart healthy. Your doctor may recommend:
- keeping track of your blood pressure and controlling it if it’s high.
- keeping track of your cholesterol and controlling it if it’s high.
- following a healthy lifestyle.
- quitting smoking, if you smoke.
Some people may need other heart testing, such as a CT scan of their chest, to check for cardiovascular disease.
4. If I have CH, what are the risks to my children?
There aren’t any risks to your children. The genetic mutation (change) that causes CH is not something you are born with. It happens during your lifetime, and only some of your blood cells have it. It can’t be passed down to your children.
5. What is MSK’s CH clinic?
At MSK’s CH clinic, we help you manage CH through education, surveillance (ser-VAY-lents), and clinical trials if you’re eligible. Surveillance means to actively monitor or watch for symptoms.
Our clinic is made up of CH experts, including hematologists (doctors with special training in the blood) and cardiologists. Certain people with CH, such as those with a low blood count or a specific genetic pattern, are at a higher risk for blood cancers. They should be monitored through regular tests. Less than 1 out of every 20 people with CH need to have this monitoring. If you do, your doctor will give you more information.
People with high-risk CH will have tests (such as blood tests or a bone marrow biopsy) to check for other blood disorders. All CH clinic patients also meet with a cardiologist to be screened for cardiovascular disease risk. This includes blood tests and sometimes other heart testing.
If you’re diagnosed with a blood disorder, the CH clinic team will work with other blood cancer experts at MSK to create a treatment plan.
Our experts see patients at the David H. Koch Center for Cancer Care at MSK at 530 East 74th Street in New York. We offer telemedicine (virtual visits) for follow-up care, as needed.
If you want more information about MSK’s CH clinic, talk with a member of your care team. To reach the CH clinic, please call 646-608-2393.
