Germline interference is generally rare among patients with cancer—CH has been recorded to interfere in just 0.3% and 0.05% of patients in two large studies of germline genetic testing.67,68 Although rare, appropriate measures must be taken to avoid the misdiagnosis of germline conditions such as Li-Fraumeni syndrome (LFS), a condition driven by mutations in the common CH gene TP53. This evidence concerns the gene TP53 and cyclic hematopoiesis.