Antecedent CHIP in CML?

Abstract

In this issue of Blood, Kim et al provide evidence that the t(9:22) translocation (ie, Philadelphia chromosome, or Ph), coding for the BCR/ABL gene rearrangement, is not always the first mutation acquired in chronic myeloid leukemia (CML).1 These results are consistent with prior smaller studies and indicate that CML can sometimes arise from a preexisting Ph-negative (Ph-) hematopoietic clone already harboring additional gene mutations. This work also adds to the growing body of evidence suggesting that BCR/ABL expression alone may not be sufficient to induce CML.