Technological advances such as the high-throughput sequencing are providing us novel aspects and perspectives of cancer stem cells (CSCs). Current evidences support a model where multiple subclones persist, rather than a simple hierarchical model with CSCs. The presence of multiple subclones contributes to increase in fitness and robustness of a cancer, which is reminiscent of the stability in ecosystems. The latest report describing the sequencing of peripheral-blood cells from unselected persons revealed that clonal hematopoiesis with somatic mutations already exists in a fair percentage of elderly persons. The analysis also shed light on some epigenetic modifiers as the driver genes of clonal hematopoiesis. In this article, we review the recent evolution of CSC model in hematology.

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