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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vavilov</journal-id><journal-title-group><journal-title xml:lang="ru">Вавиловский журнал генетики и селекции</journal-title><trans-title-group xml:lang="en"><trans-title>Vavilov Journal of Genetics and Breeding</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2500-3259</issn><publisher><publisher-name>Institute of Cytology and Genetics of Siberian Branch of the RAS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18699/vjgb-26-57</article-id><article-id custom-type="elpub" pub-id-type="custom">vavilov-5183</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МОЛЕКУЛЯРНАЯ И КЛЕТОЧНАЯ БИОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>MOLECULAR AND CELL BIOLOGY</subject></subj-group></article-categories><title-group><article-title>Концепция природной реконструкции генома. Часть 6. Анализ изменения частот встречаемости SNP в экзонах генов, ассоциированных с клональным гемопоэзом неопределенного потенциала у пациента с нейроэндокринной опухолью тонкой кишки в терминальной стадии прогрессии после модификации генома гемопоэтических стволовых клеток препаратом hDNAgr (клинический случай)</article-title><trans-title-group xml:lang="en"><trans-title>The concept of natural genome reconstruction. Part 6. Analysis of changes in the frequency of occurrence of SNPs in exons of the genes associated with clonal hematopoiesis of uncertain potential in a patient with a neuroendocrine tumor of the small intestine in the terminal stage of progression after modification of the hematopoietic stem cell genome with hDNAgr (a clinical case report)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6097-5155</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ощепков</surname><given-names>Д. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Oshchepkov</surname><given-names>D. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6836-5618</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рузанова</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Ruzanova</surname><given-names>V. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-6432-1762</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ошихмина</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Oshikhmina</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Траспов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Traspov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Обнинск</p></bio><bio xml:lang="en"><p>Obninsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5543-248X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Долгова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolgova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1573-3795</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Риттер</surname><given-names>Г. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Ritter</surname><given-names>G. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3426-4501</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кирикович</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirikovich</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3093-407X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левитес</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Levites</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0649-7543</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ефремов</surname><given-names>Я. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Efremov</surname><given-names>Y. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6746-8092</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Таранов</surname><given-names>О. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Taranov</surname><given-names>O. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>р. п. Кольцово, Новосибирская область</p></bio><bio xml:lang="en"><p>Koltsovo, Novosibirsk region</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гривцова</surname><given-names>Л. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Grivtsova</surname><given-names>L. U.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Обнинск</p></bio><bio xml:lang="en"><p>Obninsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сидоров</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sidorov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никонов</surname><given-names>С. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikonov</surname><given-names>S. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3169-8643</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Леплина</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Leplina</surname><given-names>O. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6895-938X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Останин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ostanin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2346-6279</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черных</surname><given-names>Е. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernykh</surname><given-names>E. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6800-8787</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Колчанов</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolchanov</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Брюховецкий</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Bryukhovetskiy</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2019-9382</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богачев</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogachev</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><email xlink:type="simple">labmolbiol@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук<country>Россия</country></aff><aff xml:lang="en">Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук; Новосибирский национальный государственный исследовательский университет<country>Россия</country></aff><aff xml:lang="en">Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences; Novosibirsk State University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Национальный медицинский исследовательский центр радиологии Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук<country>Россия</country></aff><aff xml:lang="en">Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences,<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru">Государственный научный центр вирусологии и биотехнологии «Вектор» Роспотребнадзора<country>Россия</country></aff><aff xml:lang="en">State Scientific Centre of Virology and Biotechnology “Vector” of Rospotrebnadzor<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru">Новосибирский национальный государственный исследовательский университет; Городская клиническая больница № 1<country>Россия</country></aff><aff xml:lang="en">Novosibirsk State University; City Clinical Hospital No. 1<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru">Государственная областная Новосибирская клиническая туберкулезная больница<country>Россия</country></aff><aff xml:lang="en">State Regional Novosibirsk Clinical Tuberculosis Hospital<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru">Научно-исследовательский институт фундаментальной и клинической иммунологии<country>Россия</country></aff><aff xml:lang="en">Research Institute of Fundamental and Clinical Immunology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru">АО Клинический госпиталь «НейроВита»<country>Россия</country></aff><aff xml:lang="en">Clinical Hospital “NeuroVita”<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>24</day><month>07</month><year>2026</year></pub-date><volume>30</volume><issue>4</issue><fpage>541</fpage><lpage>556</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ощепков Д.Ю., Рузанова В.С., Ошихмина С.Г., Траспов А.А., Долгова Е.В., Риттер Г.С., Кирикович С.С., Левитес Е.В., Ефремов Я.Р., Таранов О.С., Гривцова Л.Ю., Сидоров С.В., Никонов С.Д., Леплина О.Ю., Останин А.А., Черных Е.Р., Колчанов Н.А., Брюховецкий А.С., Богачев С.С., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Ощепков Д.Ю., Рузанова В.С., Ошихмина С.Г., Траспов А.А., Долгова Е.В., Риттер Г.С., Кирикович С.С., Левитес Е.В., Ефремов Я.Р., Таранов О.С., Гривцова Л.Ю., Сидоров С.В., Никонов С.Д., Леплина О.Ю., Останин А.А., Черных Е.Р., Колчанов Н.А., Брюховецкий А.С., Богачев С.С.</copyright-holder><copyright-holder xml:lang="en">Oshchepkov D.Y., Ruzanova V.S., Oshikhmina S.G., Traspov A.A., Dolgova E.V., Ritter G.S., Kirikovich S.S., Levites E.V., Efremov Y.R., Taranov O.S., Grivtsova L.U., Sidorov S.V., Nikonov S.D., Leplina O.Y., Ostanin A.A., Chernykh E.R., Kolchanov N.A., Bryukhovetskiy A.S., Bogachev S.S.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vavilov.elpub.ru/jour/article/view/5183">https://vavilov.elpub.ru/jour/article/view/5183</self-uri><abstract><p>В последней части цикла работ приводятся результаты пилотного исследования клинического случая (пациент К.), свидетельствующие о снижении частоты встречаемости SNP в экзонах генов, ассоциированных с клональным гемопоэзом неопределенного потенциала у пациента с нейроэндокринной опухолью тонкой кишки в терминальной стадии прогрессии при применении терапии, позволяющей реконструировать геном гемопоэтических стволовых клеток (ГСК). Основные принципы терапии состояли в следующем. У пациента отбирали контрольные образцы мононуклеаров периферической крови (нулевая точка). Затем проводились мобилизация и сбор CD34+ ГСК. Осуществляли модификацию генома ГСК с использованием технологии, позволяющей провести ex vivo коррекцию нуклеотидных последовательностей ДНК хромосом низкодифференцированных предшественников гемопоэза. Для этого собранную лейковзвесь, обогащенную CD34+ ГСК, обрабатывали фрагментированной депротеинизированной геномной ДНК, полученной от ~100 молодых здоровых рожениц (hDNAgr). Паценту внутривенно реинфузировали обработанные клетки. За 5 дней до реинфузии пациент получал иммуносупрессивную терапию. Через 4, 8, 12 и 27 мес. также забирались образцы мононуклеаров периферической крови. Было проведено полноэкзомное секвенирование ДНК, выделенной из отобранных образцов клеток. В качестве критерия, отражающего изменения в геноме, была выбрана группа общепринятых генов клонального гемопоэза. В нулевой точке, в точках через 4, 8, 12 мес. использовались мультиплексные панели: MGIEasy Exome Capture V5 Probe set, Roche KAPA HyperExome, Nanodigmbio NEXome Plus Panel v1.0, охватывающие весь экзом и некодирующие области анализируемых генов, прилегающие к экзонам с покрытием ~100×. Для верификации выявленных мутаций и более точного определения их долей в прочтениях на последнем этапе анализа, через 27 мес. после терапии, использовалась панель с покрытием ~1000× (Nanodigmbio NanOnco Plus Panel v3.0), включающая выявленные в нулевой точке гены с мутантными аллелями. Также было выполнено полноэкзомное секвенирование препарата hDNAgr (Roche KAPA HyperExome), используемого для реконструкции генома ГСК, фрагменты которого в совокупности составляют полный геном человека. Несмотря на то что анализ прочтений полноэкзомного секвенирования ДНК, выделенной из мононуклеаров крови после проведенного лечения, не позволил выявить у пациента К. известных на данный момент признаков клонального гемопоэза с неопределенным потенциалом, нами обнаружено достоверное в рамках выбранного критерия снижение диапазона частот SNP до 18 % к 27-му месяцу наблюдения в 15 % гетерозиготных аллелей (DNMT1, SF3B1(1-2)). Последующий анализ частоты встречаемости контролируемых SNP и соответствующих данных по глубине их секвенирования, выполненный с использованием алгоритма All-FIT, свидетельствует, что к 27-му месяцу наблюдения доля клеток, несущих базовый набор SNP, значимо снижается на 12 % (доверительный интервал 5–16 %). Иными словами, в смеси клеток, гетерозиготных по этим SNP, появляется популяция клеток, несущая гомозиготу без SNP. Полученные результаты могут свидетельствовать о том, что для значимой доли клеток произошла коррекция SNP на альтернативный аллель и эта коррекция связана с обработкой исходных ГСК препаратом hDNAgr, причем обнаруженные изменения в группе генов клонального гемопоэза предполагают возможность коррекции других локусов по всему геному ГСК. Как следствие, клинические проявления в развитии патологии болезни имеют ярко выраженную положительную динамику, сохраняющуюся на протяжении четырех лет, до настоящего времени. Предполагается, что положительный клинический эффект после проведенной терапии реконструированными стволовыми клетками крови связан с усилением регенеративного потенциала ГСК, произошедшего вследствие генетической коррекции неблагоприятных мутаций в геноме ГСК.</p></abstract><trans-abstract xml:lang="en"><p>The final part of our series of studies reports the results of a pilot study of a clinical case (patient K.), indicating that therapy enabling reconstruction of the genome of hematopoietic stem cells (HSCs) reduces the frequency of SNPs in exons of the genes associated with clonal hematopoiesis of uncertain potential in a patient with a neuroendocrine tumor of the small intestine in the terminal stage of progression. The fundamental principles of the therapy were as follows. Control samples of peripheral blood mononuclear cells (baseline) were collected from the patient. CD34+ HSCs were then mobilized and collected. The HSC genome was modified using a technology enabling ex vivo correction of the nucleotide sequences of DNA chromosomes of poorly differentiated hematopoietic progenitor cells. For this purpose, the collected leukocyte suspension enriched with CD34+ HSCs was treated with fragmented deproteinized genomic DNA obtained from approximately 100 young healthy women in labor (hDNAgr). The patient was reinfused intravenously with the treated cells. Five days before reinfusion, the patient received immunosuppressive therapy. Samples of peripheral blood mononuclear cells were also collected 4, 8, 12, and 27 months after the therapeutic intervention. Full-exome sequencing of DNA isolated from selected cell samples was performed. A group of commonly accepted clonal hematopoiesis genes was selected as a criterion demonstrating changes in the genome. The following multiplex panels were used at the initial time point as well as time points after 4, 8, and 12 months: MGIEasy Exome Capture V5 Probe set, Roche KAPA HyperExome, Nanodigmbio NEXome Plus Panel v1.0, covering the entire exome and non-coding regions of the analyzed genes adjacent to exons with ~100× coverage. A ~1000× coated panel (Nanodigmbio NanOnco Plus Panel v3.0), including the genes with mutant alleles identified at the initial time point, was used to verify the identified mutations and more accurately determine their proportions in readings at the last stage of the analysis (27 months after the therapy). Whole-exome sequencing of hDNAgr (Roche KAPA HyperExome), which is used to reconstruct the genome of HSCs whose fragments collectively constitute the complete human genome, was also performed. Although the analysis of readings of whole-exome sequencing of DNA isolated from blood samples after treatment did not reveal any currently known signs of clonal hematopoiesis with uncertain potential in the patient K., we found a significant, within the framework of the selected criterion, decrease in the frequency range of SNPs to 18 % by 27 months of follow-up in 15 % cases of the heterozygous alleles (DNMT1, SF3B1(1–2)). Subsequent analysis of the frequency of occurrence of controlled SNPs and the corresponding data on the depth of their sequencing, performed using the All-FIT algorithm, indicates that by the 27th month of follow-up, the proportion of cells carrying the basic set of SNPs significantly decreases by 12 % (confidence interval (CI) = 5–16 %). In other words, in a mixture of cells heterozygous for this SNP, a population of cells carrying a homozygote without an SNP appears. Our findings may indicate that a significant proportion of cells underwent correction of the SNP to an alternative allele, and this correction was associated with the treatment of the original HSCs with hDNAgr. The detected changes in the group of clonal hematopoiesis genes suggest the possibility of correcting other loci throughout the HSCs genome. Therefore, the clinical manifestations in the development of the disease show a pronounced positive trend, which has persisted for four years, until present. It is assumed that the positive clinical outcome after therapy with reconstructed hematopoietic stem cells is associated with an increase in the regenerative potential of HSCs, which resulted from the genetic correction of unfavorable mutations in the HSCs genome.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>клональный гемопоэз</kwd><kwd>нейроэндокринная опухоль</kwd><kwd>технология реконструирования генома</kwd><kwd>полногеномное секвенирование</kwd><kwd>гемопоэтические стволовые клетки</kwd></kwd-group><kwd-group xml:lang="en"><kwd>clonal hematopoiesis</kwd><kwd>neuroendocrine tumor</kwd><kwd>genome reconstruction technology</kwd><kwd>whole-genome sequencing</kwd><kwd>hematopoietic stem cells</kwd></kwd-group><funding-group xml:lang="en"><funding-statement>This work was conducted at the Institute of Cytology and Genetics and supported by the Ministry of Science and Higher Education of the Russian Federation (state budget-funded project No. FWNR-2026-0025), I.N. 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