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Much less is known about the clonal composition of haematopoiesis and its impact in bone marrow failure (BMF) disorders, including Fanconi anaemia (FA). Understanding clonality in FA is likely to inform both the marked predisposition to cancer and the rapid erosion of regenerative reserve seen with this disease. This may also hold broader lessons for haematopoietic stem cell biology in other diseases with a clonal restriction. In this review, we focus on the conceptual basis and available tools to study clonality, and highlight insights in somatic mosaicism and malignant evolution in FA in the context of haematopoietic failure and gene therapy.<\/jats:p>","DOI":"10.1111\/bjh.17653","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T05:27:08Z","timestamp":1626240428000},"page":"274-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The impact of clonal diversity and mosaicism on haematopoietic function in Fanconi anaemia"],"prefix":"10.1111","volume":"196","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-2404","authenticated-orcid":false,"given":"Andrew D.","family":"Hughes","sequence":"first","affiliation":[{"name":"Comprehensive Bone Marrow Failure Center Children\u2019s Hospital of Philadelphia  Philadelphia PA 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