Examining telomere dysfunction in multiple myeloma

Telomeres are repetitive nucleotide sequences of TTAGGG that cap the ends of linear eukaryotic chromosomes. Short dysfunctional telomeres have previously been identified as a driving force in cancer, resulting in chromosomal fusion and rearrangement that acts to facilitate progression of the malignancy. As it has recently been demonstrated that telomere length is an accurate predictor of clinical outcome in patients with chronic lymphocytic leukaemia (CLL), we aimed to determine whether a similar relationship existed in multiple myeloma (MM). Having used single telomere length analysis (STELA) to measure the mean XpYp telomere length of whole bone marrow aspirates from 141 MM patients, a telomere length threshold of 3.92kb was identified which could be used to stratify patients as either low- or high-risk. Incorporation of this threshold into the international staging system (ISS) for MM increased its prognostic resolution, allowing each prognostic subset to be further risk-stratified. Having demonstrated that a shorter mean XpYp telomere length (