Aging is a multifaceted process characterized by a gradual decline in physiological function and increased susceptibility to a range of chronic diseases. Among the molecular and cellular mechanisms driving aging, genomic instability is a fundamental hallmark, contributing to increased mutation load and genetic heterogeneity within cellular populations. This review explores the role of genomic instability and genetic heterogeneity in aging in the hematopoietic system, with a particular focus on clonal hematopoiesis of indeterminate potential (CHIP), monoclonal gammopathy of undetermined significance (MGUS), and monoclonal B-cell lymphocytosis (MBL) as biomarkers. CHIP involves the clonal expansion of hematopoietic stem cells with somatic mutations. In contrast, MGUS is characterized by the presence of clonal plasma cells producing monoclonal immunoglobulins, while MBL is characterized by clonal proliferation of B cells. These conditions are prevalent in the aging population and serve as measurable indicators of underlying genomic instability. Studying these entities offers valuable insights into the mechanisms by which somatic mutations accumulate and drive clonal evolution in the hematopoietic system, providing a deeper understanding of how aging impacts cellular and tissue homeostasis. In summary, the hematopoietic system serves as a powerful model for investigating the interplay between genomic instability and aging. Incorporating age-related hematological conditions into aging research, alongside other biomarkers such as epigenetic clocks, can enhance the precision and predictive power of biological age assessments. These biomarkers provide a comprehensive view of the aging process, facilitating the early detection of age-related diseases and hopefully enabling personalized healthcare strategies.

衰老是一个多方面的过程，其特征是生理功能逐渐下降，对一系列慢性疾病的易感性增加。在驱动衰老的分子和细胞机制中，基因组不稳定性是一个基本标志，导致细胞群内突变负荷增加和遗传异质性。本文探讨了基因组不稳定性和遗传异质性在造血系统衰老中的作用，特别关注不确定电位的克隆造血 （CHIP）、意义未明的单克隆丙种球蛋白病 （MGUS） 和单克隆 B 细胞淋巴细胞增多症 （MBL） 作为生物标志物。CHIP 涉及具有体细胞突变的造血干细胞的克隆扩增。相比之下，MGUS 的特征是存在产生单克隆免疫球蛋白的克隆浆细胞，而 MBL 的特征是 B 细胞的克隆增殖。这些情况在老龄化人口中普遍存在，是潜在基因组不稳定性的可衡量指标。研究这些实体为了解体细胞突变积累并驱动造血系统中克隆进化的机制提供了有价值的见解，从而更深入地了解衰老如何影响细胞和组织稳态。总之，造血系统是研究基因组不稳定性和衰老之间相互作用的有力模型。将与年龄相关的血液学疾病与其他生物标志物（如表观遗传时钟）一起纳入衰老研究，可以提高生物年龄评估的准确性和预测能力。 这些生物标志物提供了衰老过程的全面视图，有助于早期发现与年龄相关的疾病，并有望实现个性化的医疗保健策略。