Clinical and pathologic challenges of clonal cytopenia of undetermined significance

Abstract Unexplained blood cytopenias, in particular anemia, are often found older individuals. The relationship between these cytopenias and myeloid neoplasms like myelodysplastic syndromes is currently poorly defined. Terminology used to describe patients with unexplained clonally restricted hematopoiesis can be confusing evolving. This review uses a complex clinical case borderline morphology somatic mutations high variant allele frequencies illustrate diagnostic approach clonal differentiation from focus on appropriate ancillary testing. Testing for frequency helpful assessing risk progression malignancy. interpretation of mutation profiles cytopenia has been challenging, as some genes commonly detected elderly adults showing normal count well individuals nonmalignant bone marrow failure syndromes. For longitudinal follow‐up including monitoring counts may also appropriate.