DNMT3A and cyclic hematopoiesis: A small study of patients with metastatic renal cell carcinoma found CH in 43% of patients, negatively affecting overall survival.59 Sequencing of metastatic breast cancer specimens found that CH may be dictating bone metastasis, with enrichment for DNMT3A mutations in the samples found in a pattern resembling CH.60 Although these findings are notable, they are nonetheless incidental, and the conclusions that can be drawn from them are limited.