A new telomere-based test has been devised that could predict survival in people with some blood cancers, researchers in Cardiff, UK, have announced.
Technology that can detect the length of telomeres in cancer cells could hold the key to predicting the outcome of patients with two different types of blood cancer, say scientists.
Researchers from Cardiff University’s School of Medicine demonstrated that the technique is a highly accurate indicator of how disease will progress in patients with myeloma and pre-leukaemia myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML).
Results from two studies are published in the British Journal of Haematology and describe how the Cardiff team analysed samples from 134 myeloma patients, 80 MDS patients and 95 AML patients to see whether telomere length influences survival in these blood cancers.
After extracting chromosomes from the patients’ cancer cells, Single Telomere Length Analysis (STELA) was used to measure telomere length in each sample. Telomere length was then checked against patients’ medical records to analyse its impact on disease progression and survival.
The team found that while the existing system to predict survival was generally a good indicator of survival times, telomere length had a significant independent impact on survival.
Myeloma patients who had a "good" or "standard" risk score under the current system, but had short telomeres, had the same average survival times as patients in the ‘high risk’ group who had long, functional telomeres.
Of the patients who had long telomeres in the "good" or "standard" risk groups, 55% lived for more than 16 years, compared with 21% in the same risk groups who had short telomeres.
Most of the patients with MDS were judged to be "low risk" under standard assessment, and had only received treatment to control their symptoms. The researchers found that 7% of MDS patients with short telomeres survived for more than eight years compared with 46% of patients with long telomeres.
Professor Duncan Baird, who led the research with Professors Chris Fegan and Chris Pepper, said: 'We really need to improve the way we predict how an individual patient’s myeloma or MDS will behave, as these conditions can vary widely in outcome.
'Our research provides strong evidence that shortening of telomeres plays a vital role in the progression of these blood cancers and that a significant number of patients should be receiving different levels of treatment.
'The next step is to assess telomere length in larger studies to establish how it can be integrated into existing assessments that predict patient outcome.'
Dr Alasdair Rankin, director of research at Bloodwise, which helped to fund the research with Cancer Research UK, added: 'Measuring telomere length could have great potential in helping doctors better predict the risk of disease progression for individual patients.
'This could both help patients dealing with the uncertainty of how their blood cancer will progress, and help doctors better tailor the right treatments for individual patients based on their individual predictive progression risk.'
Williams J, Heppel N, Britt-Compton B et al. Telomere length is an independent prognostic marker in MDS but not in de novo AML. British Journal of Haematology May 2017.
Hyatt S, Jones RE, Heppel NH et al. Telomere length is a critical determinant for survival in multiple myeloma. British Journal of Haematology May 2017; doi: 10.1111/bjh.14643
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