The Center for Early Detection and Interception of Blood Cancers cares for patients diagnosed with – or at high risk for – precursor conditions of hematologic malignancies, including:
Clonal Hematopoiesis of Indeterminate Potential (CHIP)
In CHIP, some blood-forming stem cells acquire leukemia-associated mutations and contribute more than their share to blood cell development. Individuals with CHIP don't have symptoms or obvious abnormalities in their blood counts, but Dana-Farber research has shown CHIP to have an increased risk for blood cancers such as acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPNs). The rate of transformation from CHIP to blood cancers is around 1% per year.
Clonal Cytopenias of Undetermined Significance (CCUS) and Idiopathic Cytopenias of Undetermined Significance (ICUS)
Sometimes patients with low blood counts undergo further evaluation, including bone marrow and blood tests, but no specific cause is found for the low blood counts. These patients have unexplained low blood counts or "idiopathic cytopenias of undetermined significance" (ICUS) and the risk of blood cancer development is variable. The subset of these patients who have mutations similar to those observed in CHIP are diagnosed with "clonal cytopenia of undetermined significance" (CCUS). The risk of developing acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) or myeloproliferative neoplasm (MPN) is higher in CCUS than in CHIP.
Plasma Cell Precursors
Monoclonal Gammopathy of Undetermined Significance (MGUS)
MGUS is a condition in which there are abnormal plasma cells in the bone marrow, but there is no cancer. The abnormal plasma cells produce monoclonal (M) protein. In most patients, the amount of M protein stays the same, and there are no symptoms or problems. In some patients, MGUS may later become a more serious condition or cancer, such as multiple myeloma, lymphoma, Waldenström's macroglobulinemia, or AL amyloidosis.
Smoldering Multiple Myeloma (SMM)
Smoldering myeloma is a precursor condition in which high concentrations of abnormal plasma cells are found in the bone marrow and secrete monoclonal (M) proteins and/or free light-chains (FLCs). Smoldering myeloma may progress to multiple myeloma.
Immunoglobulin M Monoclonal Gammopathy of Undetermined Significance (IgM MGUS)
IgM MGUS is a sub-type of MGUS that can develop into Waldenström macroglobulinemia or other slow-growing B-cell cancers. Most patients with IgM MGUS will not experience symptoms, but the IgM protein itself may cause conditions that are not cancer.
Smoldering Waldenström Macroglobulinemia (SWM)
SWM is a precursor condition characterized by increased IgM antibodies but no symptoms. SWM may progress to overt Waldenström macroglobulinemia, a rare, slow-growing type of non-Hodgkin lymphoma.
Monoclonal B-cell Lymphocytosis (MBL)
Monoclonal B-cell lymphocytosis (MBL) is very common in people older than 50 years and can be a precursor condition to chronic lymphocytic leukemia (CLL). Most people who develop CLL have had MBL, and about 1 percent per year will convert to CLL. MBL also predisposes to non-Hodgkin lymphoma.
Lymphoid Clonal Hematopoiesis (L-CH)
In L-CH, blood-forming stem cells may have lymphoma or CLL-associated mutations in patients without any signs or symptoms of a blood cancer. Individuals with L-CH have an increased risk of developing lymphoid blood cancers, including lymphoma and CLL.
Marginal Zone Lymphoma (MZL)
Marginal zone lymphoma is a group of slow-growing B-cell non-Hodgkin lymphomas. All types of MZL start in lymphoid tissues, including skin, lymph nodes, or spleen. Rarely, MZL can transform into a faster-growing lymphoma.
Follicular lymphoma is the most common type of slow-growing B-cell non-Hodgkin lymphoma. In some cases, follicular lymphoma can transform into a fast-growing lymphoma, usually one called diffuse large B-cell lymphoma (DLBCL).