We examined the leukocyte relative telomere length (RTL) in Korean adolescent and young adult (AYA) survivors of childhood cancer and evaluated the association of leukocyte RTL with multiple factors, including malignancy type, cancer treatment, age, and chronic health conditions (CHCs). Eighty-eight AYA survivors of childhood cancer with a median follow-up period of 73 months were recruited. RTL in pediatric cancer survivors was not significantly shorter than the predicted value for age-matched references. Neither age at diagnosis nor duration of therapy influenced the RTL. Among the 43 patients with hematologic malignancies, those who underwent allogeneic hematopoietic stem cell transplantation (HSCT) showed a significant shortening of the RTL compared with those who did not (p= 0.039). Among the 15 patients who underwent allogeneic HSCT, those who developed acute graft-versus-host disease (GVHD) of grade II or higher had significantly shorter RTL than those who did not (p= 0.012). Patients with grade II CHCs had significantly shorter RTL than those without CHCs or with grade I CHCs (p= 0.001). Survivors with ≥2 CHCs also exhibited shorter RTL (p= 0.027). Overall, pediatric cancer survivors had similar telomere lengths compared to age-matched references. HSCT recipients and patients with severe or multiple CHCs had shorter telomeres. GVHD augmented telomere attrition in HSCT recipients.
本研究探讨了韩国儿童癌症青少年及年轻成人（AYA）幸存者的白细胞相对端粒长度（RTL），并评估了白细胞RTL与恶性肿瘤类型、癌症治疗方式、年龄及慢性健康状况（CHCs）等多种因素之间的关联。研究共纳入88名儿童癌症AYA幸存者，中位随访期为73个月。结果显示，儿童癌症幸存者的RTL与年龄匹配对照组的预测值相比未显著缩短。确诊年龄与治疗持续时间均未对RTL产生显著影响。在43例血液系统恶性肿瘤患者中，接受异基因造血干细胞移植（HSCT）者的RTL较未接受移植者显著缩短（p=0.039）。在15例接受异基因HSCT的患者中，发生II级及以上急性移植物抗宿主病（GVHD）者的RTL显著短于未发生者（p=0.012）。患有II级CHCs的患者RTL显著短于无CHCs或仅患I级CHCs者（p=0.001）。同时患有≥2种CHCs的幸存者也表现出更短的RTL（p=0.027）。总体而言，儿童癌症幸存者的端粒长度与年龄匹配对照组相近，但接受HSCT治疗及患有严重或多重CHCs的患者端粒长度较短，且GVHD会加剧HSCT受者的端粒损耗。
Telomere Length in Adolescent and Young Adult Survivors of Childhood Cancer
肿瘤(癌症)患者之家