Telomere length is a critical determinant for survival in multiple myeloma.
The variable clinical outcomes of Multiple Myeloma (MM) patients are incompletely defined by current prognostication tools. We examined the clinical utility of high-resolution telomere length analysis as a prognostic marker in MM. Cohort stratification, using a previously determined length threshold for telomere dysfunction, revealed that patients with short telomeres had a significantly shorter overall survival (P < 0·0001; HR = 3·4). Multivariate modelling using forward selection identified International Staging System (ISS) stage as the most important prognostic factor, followed by age and telomere length. Importantly, each ISS prognostic subset could be further risk-stratified according to telomere length, supporting the inclusion of this parameter as a refinement of the ISS.
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Sam
S
Hyatt
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Rhiannon E
RE
Jones
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Nicole H
NH
Heppel
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Julia W
JW
Grimstead
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Chris
C
Fegan
Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Graham H
GH
Jackson
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Robert
R
Hills
Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne, UK.
James M
JM
Allan
Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Guy
G
Pratt
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Chris
C
Pepper
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Duncan M
0000-0001-8408-5467
DM
Baird
D004273:DNA, Neoplasm / Q000235:genetics; D042822:Genomic Instability; D006801:Humans; D053208:Kaplan-Meier Estimate; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000235:genetics; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D059506:Telomere Shortening
D004273:DNA, Neoplasm
genome instability; multiple myeloma; prognosis; telomere