03.30.21

Telomere length association with NRM in MDS post-SCT

The following content was featured in a recent Abstracts newsletter distributed by ASTCT. The Abstracts newsletter highlights the latest research in the clinical research and translational science studies aspects of transplantation and cellular therapy. 

Myllymäki M, Redd R, Reilly CR, et al. Short Telomere Length Predicts Nonrelapse Mortality After Stem Cell Transplantation for Myelodysplastic Syndrome. Blood. 2020; 136 (26): 3070 (doi: 10.1182/blood.2020005397).

Telomere length is a strong predictor of post-allogeneic hematopoietic stem cell transplantation nonrelapse mortality (NRM) in patients with myelodysplastic syndrome (MDS), especially among those with severe acute graft-versus-host disease. For the study, researchers looked at the relative telomere length in pretransplant recipient blood samples for 1,514 people with MDS and examined the association of telomere length with characteristics of MDS and transplantation outcomes. A significant association was observed between shorter telomere length and older age, male gender, somatic mutations that hinder DNA damage response, and pretransplant cytopenias of greater severity. However, bone marrow blast count, MDS treatment history, and history of prior cancer therapy were not major variables. An analysis of 1,267 patients ≥40 years old found telomere length in the shortest quartile was affiliated with inferior survival, due to an elevated NRM risk following adjustment for significant clinical and genetic factors. The adverse impact of shorter telomeres on NRM was most notable following higher intensity conditioning and in patients who developed severe acute graft-versus-host disease.

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