“…A cell autonomous increase in human adult bone marrow HSC self-renewal has been considered as the main driving force for clonal hematopoiesis, rather than neutral genetic drift [ 252 ]. Although clonal hematopoiesis is often mediated by dysregulated epigenetic control mechanisms, other stressors, such as chronic low-grade inflammation (inflamm-aging) and alterations in cellular metabolism during aging, are thought to confer a competitive advantage to the expansion of the affected hematological clones [ 4 , 10 , 291 , 292 , 293 , 294 , 295 , 296 , 297 , 298 , 299 , 300 , 301 ]. Given the excellent comprehensive reviews on developmental- and age-related changes in HSC metabolism and/or inflamm-aging [ 10 , 292 , 293 , 294 , 295 , 296 , 297 , 298 , 299 ], we restrict this section to a brief overview of more recent studies on the role of mitochondria and lysosomes in regulating HSC fate before focusing on the contribution of inflamm-aging and altered metabolism to clonal hematopoiesis driven by mutations in the epigenetic modifier genes, DNMT3A , an epigenetic writer, and TET2 , an epigenetic eraser, both of which, as indicated above, play significant roles in CHIP development.…”