Prefibrotic bone marrow microenvironment is a hallmark of clonal hematopoiesis.

Fibro-inflammatory remodeling is a hallmark of clonal hematopoiesis of indeterminate potential, with fibroblasts expanding and acquiring cancer-associated transcriptional states.

• Why it matters: Understanding how clonal hematopoiesis reshapes the bone marrow microenvironment is crucial because it is linked to systemic inflammation and increased malignant risk, yet remains poorly understood.
• What they did: Using single-cell transcriptomics, histology, and spatial transcriptomics on human bone marrow samples, the study identified fibroblast expansion, extracellular matrix changes, and inflammatory hubs associated with clonal hematopoiesis.
• The result: These findings suggest fibro-inflammatory bone marrow remodeling as a key feature of clonal hematopoiesis, potentially facilitating progression to overt malignancy through niche reorganization.