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Solimando et al. J Cancer Metastasis Treat 2022;8:9  https://dx.doi.org/10.20517/2394-4722.2021.166  Page 9 of 12

               stated above, the correct treatment of the inflammatory state is of fundamental importance in the therapy of
               these patients to restore the correct hematopoiesis and physiological homeostasis. The mutations in HSC
               due to increased stressor-specific fitness can be neutral under homeostasis. Nonetheless, their imposed
               increased self-renewal under immune attack, inflammation of genotoxic stress, can lead to the expansion of
               the mutated clone. Finally, in inherited bone marrow failure syndrome, somatic mutations may result in
               near normalization of the stem cell fitness primarily due to the correction of the underlying HSC defect,
               leading to partial restoration of normal hematopoiesis.


               DECLARATIONS
               Authors’ contributions
               Conceptualization: Solimando AG, Ria R
               Writing: Solimando AG, Melaccio A
               Review and editing: Ria R, Vacca A
               All authors have read and agreed to the published version of the manuscript.


               Availability of data and materials
               Not applicable.


               Financial support and sponsorship
               This work was supported by: INNOLABS-Programma Operativo Regionale (POR) Puglia Fondo Europeo
               di Sviluppo Regionale (FESR)-Fondo Sociale Europeo (FSE) 2014 to 2020 Telemielomedicina/Telemielolab
               (Vacca A) and by Apulian Regional project: Precision Medicine number 06062019 (Solimando AG).


               Conflicts of interest
               All authors declared that there are no conflicts of interest.


               Ethical approval and consent to participate
               Not applicable.


               Consent for publication
               Not applicable.

               Copyright
               © The Author(s) 2022.

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