Prefibrotic bone marrow microenvironment is a hallmark of clonal hematopoiesis.

Fibro-inflammatory remodeling in bone marrow is a defining feature of clonal hematopoiesis of indeterminate potential, with a significant expansion of fibroblasts and extracellular matrix changes.

• Why it matters: Understanding how clonal hematopoiesis alters the bone marrow microenvironment is crucial because it is linked to systemic inflammation and increased cancer risk, yet the underlying tissue changes remain unclear.
• What they did: The study used single-cell transcriptomics, histology, and spatial transcriptomics on freshly isolated bone marrow samples to identify fibro-inflammatory changes and spatial inflammatory hubs associated with clonal hematopoiesis.
• The result: Findings reveal that this remodeling creates proinflammatory niches that may promote progression to malignancy, providing insights into early stromal alterations that could be targeted for intervention.