VJHemOnc Podcast CHIP & CCUS: advances in understanding and should we treat these precursor conditions?
Jun 20, 2025
George Vassiliou, a Professor at The University of Cambridge specializing in clonal hematopoiesis, engages in a riveting discussion on CHIP and CCUS. He highlights the role of liquid biopsies in detecting these precursor conditions and the significance of early intervention. The conversation also covers the independent risks of monoclonal B-cell lymphocytosis alongside CHIP, showcasing how these can elevate the risk of lymphoid malignancies. The experts ponder the balance between the anxiety of treatment and the advantages of preventative measures in managing these conditions.
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Key Insights on Clonal Hematopoiesis
- Clonal hematopoiesis involves slow, steady growth of a single cell lineage over years, with mutation types and age affecting clone expansion.
- Certain mutations and larger clone sizes predict higher malignancy risk, making early identification critical.
Detection of CHIP and CCUS Advances
- Advances in detection technologies like liquid biopsies reveal more patients with CHIP and CCUS, raising challenges in managing these cases.
- Differentiating high-risk clonal cytopenias from low-risk phenotypes remains a key clinical challenge.
Genetic Drivers in CHIP and CCUS
- Majority of CHIP and CCUS cases are driven by 10-12 key genes, with DNMT3A, TET2, and ASXL1 being most common but lower risk.
- High-risk mutations include splicing factor genes and TP53, marking targets for potential preventive interventions.