Clonal Hematopoiesis of Indeterminate Potential (CHIP)

Clonal hematopoiesis of indeterminate potential (CHIP) is when blood tests find abnormal blood stem cells with genetic changes (mutations) that are early blood cancer signs. In CHIP, however, you don’t have cancer symptoms and follow-up tests don’t find cancer. But having this condition does increase your risk of blood cancer.

At the same time, genetic changes in the cell that create cancer also trigger chronic (long-term) inflammation. This may increase your risk of heart disease.

CHIP stands for:

• Clonal: This refers to clonal expansion, when cells quickly make identical or clonal cells. The genetic change in CHIP involves driver genes that help cells grow more quickly.
• Hematopoiesis: This is the way your body makes new blood cells to replace old ones. Blood cell production takes place in your bone marrow, which makes stem cells, including blood stem cells.
• Indeterminate potential: This means providers don’t know all the ways that this condition may affect you. Research shows CHIP may be a sign that you may develop blood cancers. It’s also an early warning for heart attack or stroke.

Symptoms of this condition

Clonal hematopoiesis of indeterminate potential doesn’t cause symptoms. You may find out you have this if a routine blood test detects abnormal blood cells.

Causes of clonal hematopoiesis of indeterminate potential

Genetic changes that happen during your lifetime cause this condition. These changes happen after you’re born. Many things may trigger them and increase your risk. Those risk factors include:

• Age: Studies show CHIP affects 10% of people aged 70 and older, and more than 20% of people aged 70 to 90.
• Cancer treatment: Having chemotherapy and radiation therapy may increase your risk.
• Certain medical conditions: Having a history of autoimmune disease, heart disease or stroke may be risk factors.
• Lifestyle: Smoking cigarettes increases your risk.
• Sex: Men are more likely to have it.

How doctors diagnose this condition

Healthcare providers check blood samples for specific genetic changes that cause clonal hematopoiesis of indeterminate potential. The tests also help providers estimate your risk of developing blood cancer and heart disease.

How is CHIP treated?

If you have this condition, treatment may include:

• Active surveillance to watch for signs and symptoms of blood cancer and heart disease
• Preventive steps, like managing cholesterol and blood pressure if you’re at risk for heart disease

There are clinical trials that are assessing medications that may slow down fast-growing abnormal blood cells that lead to blood cancer. If genetic tests show you’re at risk for blood cancer, ask your healthcare provider about participating in a clinical trial.

When should I see my healthcare provider?

Having clonal hematopoiesis of indeterminate potential increases your risk of heart disease and blood cancer, among other serious diseases. If tests detect this condition, you’ll probably have frequent check-ups and tests to check for heart disease or blood cancer.

Does having CHIP mean I will have blood cancer or heart disease?

No, but it does increase your risk. If CHIP increases your heart disease risk, your healthcare team will recommend things you can do to protect your heart health. If you’re at risk for blood cancer, your team will keep a close eye on your health and take steps to treat blood cancer early on.