Hyatt Sam, Jones Rhiannon E, Heppel Nicole H, Grimstead Julia W, Fegan Chris, Jackson Graham H, Hills Robert, Allan James M, Pratt Guy, Pepper Chris, Baird Duncan M
Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Br J Haematol. 2017 Jul;178(1):94-98. doi: 10.1111/bjh.14643. Epub 2017 Mar 24.
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.
多发性骨髓瘤（MM）患者的临床结局各异，目前的预后评估工具尚不能完全明确其原因。我们研究了高分辨率端粒长度分析作为MM预后标志物的临床实用性。采用先前确定的端粒功能障碍长度阈值进行队列分层，结果显示端粒短的患者总生存期显著缩短（P < 0·0001；HR = 3·4）。采用向前选择法进行多变量建模，结果表明国际分期系统（ISS）分期是最重要的预后因素，其次是年龄和端粒长度。重要的是，每个ISS预后亚组均可根据端粒长度进一步进行风险分层，这支持将该参数纳入ISS，以对其进行优化。
