What is clonal evolution?
So clonal evolution has to do with changes that occur in the MDS group of cells. And so basically as a patient experiences clonal evolution, it's usually associated with worsening disease severity and progression of the disease. As that happens we can see that new genetic mutations arise at the same time. So that kind of is a marker of the disease kind of progressing, worsening, maybe heading toward true AML.
Clonal evolution basically means it's a process by which a clone of cells evolve over time. So, basically a clone is a population of cells that have the same genetic profile, compared to, for example, other neighboring cells. For example, if there are a million cells of a clone, they all have the same genetic materials. They have the same genetic mutations that cause a person to have MDS or any type of cancer.
So clonal evolution means there can be a change in the genetic profiles that make up that clone. An example in a patient would be a patient with MDS where that MDS is caused by a clone of cells that have this particular mutation. That led someone to have MDS. Over time, if that patient gets chemotherapy, their clone can change because chemotherapy can eliminate those cells, either completely or partially. So that clone disappears or decreases in number.
So when you check for those clones in 2 to 3 months from now, you may not even see that particular clone of cells. But at the same time, there can be a subclone, which is another clone of cells with another genetic profile. They can become more dominant over time, and they can appear in the next 2 to 3 months. So it's a dynamic process. Genetic profiles and genetic mutations can change over time, whether that's due to chemotherapy, whether that's relapse. Someone can gain a mutation and develop another new, different clone, which becomes either more aggressive or more resistant to chemotherapy.
You can define it as a change of genetic profile over time that caused the MDS or cancer itself.
HealthTree • March 29, 2026
