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Allogeneic hematopoietic stem cell transplantation is the only potential cure for patients with marrow growth syndrome (MDS), but long-term survival is limited by the risk of transplant-related complications.
short telomere length, mediated by genetic or access factors, weakens the cell's response to genotoxicity and replicatative stress, and can identify patients with a higher risk of toxicity after transplantation.
Lindsley and others tested the relative telomere length of 1,514 MDS patients in a pre-transplant blood sample and assessed the correlation between telomere length and MDS disease characteristics and transplant prognostics.
results showed that short telomere lengths were significantly associated with somatic cell mutations and pre-transplant severe blood cell reduction in patients who were older, male, and affected DNA damage repair, but were not significantly related to marrow maternal cell count, MDS treatment history, or past cancer treatment history.
(C: Relationship between telomere length and overall patient survival time; D: Relationship between telomere length and patient non-recurrence mortality) In 1267 patients aged 40, the shortest treadile telomere length was associated with poor survival because of the high risk of non-relapsed death (NRM) (after correction by important clinical and genetic variables).
adverse effects of short telomeres on NRM were not associated with complications in transplant patients and were selective in patients undergoing intensive chemotherapy, including clear myelin therapy and low-intensity therapy with high doses of mefarene.
effect of short telomeres on NRM is most evident in patients with severe acute graft anti-host disease, suggesting that short telomere length may limit the regenerative potential of mucous membrane tissue after acute injury.
, patients with MDS with shorter telomere lengths may have poor survival prognostics due to excessive toxicity, and strategies designed to minimize the toxicity of the graft may be considered.
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