Table 2.

The unique clinical features differentiating ICUS, CHIP, CCUS, and MDS

ICUSCHIPCCUSMDS
Cytopenias − 
Somatic mutations − 
Morphologic dysplasia − − − 
Increased blasts − − − ± 
Risk of transformation to AML Very low Very low Low Low to very high 
Suggested management and follow-up* - CBC with differential, history, and physical annually or semiannually - Routine health maintenance.
- Consider annual CBC with differential
- Assess cardiovascular risk 
- CBC with differential every 3-6 mo
- History and physical annually or semiannually
- Repeat bone marrow biopsy if counts worsen
- Assess cardiovascular risk 
Treatment per stage- specific guidelines 
ICUSCHIPCCUSMDS
Cytopenias − 
Somatic mutations − 
Morphologic dysplasia − − − 
Increased blasts − − − ± 
Risk of transformation to AML Very low Very low Low Low to very high 
Suggested management and follow-up* - CBC with differential, history, and physical annually or semiannually - Routine health maintenance.
- Consider annual CBC with differential
- Assess cardiovascular risk 
- CBC with differential every 3-6 mo
- History and physical annually or semiannually
- Repeat bone marrow biopsy if counts worsen
- Assess cardiovascular risk 
Treatment per stage- specific guidelines 

+, present; −, absent.

*

Evidence-based guidelines for management of CHIP, CCUS, and idiopathic dysplasia of unknown significance are currently lacking. Follow-up should be tailored to each patient's individual risk and needs.

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