髓样肿瘤包括急性髓系白血病、骨髓增生异常综合征和髓增生性肿瘤。大多数病例起源于克隆造血（CH）的共同祖先。在这里，我们分析了来自454,340名英国生物库参与者的数据，其中1,808名在招募后0-15年内发展为髓样肿瘤。我们描述了那些后来发展为髓样肿瘤的个体（预- MN）与对照群之间在CH基因突变谱和血液学/生化检测参数方面的差异，发现疾病特异性变化可在诊断前多年发现。通过分析'预-MN'和对照群之间的差异，我们开发并验证了Cox回归模型，用于量化转化为每种髓样肿瘤亚型的风险。我们构建了“MN-predict”一个基于基本血液检测和基因数据的输入生成时间依赖预测的 web应用程序。我们的研究证明，许多发展为髓样肿瘤的个体可以提前数年被鉴定，并提供了疾病特异性预后的框架，这对研究人员和医生来说将非常有用。© 2023年。作者。

The myeloid neoplasms encompass acute myeloid leukemia, myelodysplastic syndromes and myeloproliferative neoplasms. Most cases arise from the shared ancestor of clonal hematopoiesis (CH). Here we analyze data from 454,340 UK Biobank participants, of whom 1,808 developed a myeloid neoplasm 0-15 years after recruitment. We describe the differences in CH mutational landscapes and hematology/biochemistry test parameters among individuals that later develop myeloid neoplasms (pre-MN) versus controls, finding that disease-specific changes are detectable years before diagnosis. By analyzing differences between 'pre-MN' and controls, we develop and validate Cox regression models quantifying the risk of progression to each myeloid neoplasm subtype. We construct 'MN-predict', a web application that generates time-dependent predictions with the input of basic blood tests and genetic data. Our study demonstrates that many individuals that develop myeloid neoplasms can be identified years in advance and provides a framework for disease-specific prognostication that will be of substantial use to researchers and physicians.© 2023. The Author(s).