COUNTERPOINT Stem cell donors should not be screened for clonal hematopoiesis

The current level of evidence is insufficient to support implementation of prospective screening of donors for clonal hematopoiesis. Further, without clear consensus guidelines for interpretation of results, standardized methodological approaches, and clinical infrastructure for donor notification and counseling, there is a potential for unintended negative consequences of screening. Because our conclusion is based on the lack of demonstrated actionability of a positive screening result, we further emphasize that the pretest likelihood of finding CH in a potential donor, informed by older age or relatedness, does not factor into our recommendation. Additional retrospective and prospective studies of donor CH that are adequately powered to engage the scientific questions outlined here may clarify the magnitude of risk or benefit associated with donor CH, thereby prompting reevaluation of this assessment. © 2020 by The American Society of Hematology.