With aging, the number of somatic mutations in the hematopoietic compartment increases, leading to the evolution of clonal hematopoiesis of indeterminate potential (CHIP). In some patients, CHIP progresses towards stem cell-driven pre-neoplastic conditions such as myelodysplastic neoplasms (MDS). However, the underlying process has not been defined. Elderly patients without hematologic disease have a high prevalence of CHIP, which is associated with low hemoglobin and inflammatory diseases. Mesenchymal stromal cells (MSC) from patients with CHIP display a proinflammatory phenotype compared to non-CHIP. In addition, in CHIP stress-induced cytotoxic T cells developed. In parallel, the regulatory T cells demonstrated exhaustion in both CHIP and MDS. However, reduced bone mineral density was only present in MDS and linked to anemia. Despite this low-grade inflammation, there is still no relevant bone loss in CHIP; longer follow-up may be required to detect bone loss and fractures.