Donor telomere length affects survival after hematopoietic cell transplantation for severe aplastic anemia



Hematopoietic cell transplantation (HCT), also referred to as blood and bone marrow stem cell transplantation, can be a curative therapy for patients with severe aplastic anemia (SAA). Although survival following HCT for SAA has improved over the last decade, transplants from unrelated donors generally result in poorer outcomes than those from matched sibling donors. Since sibling donors are not always available, approximately two-thirds of patients will have an unrelated donor.


IRP researchers led by Shahinaz Gadalla, M.D., Ph.D., found that among SAA patients below the age of 40 who received an unrelated donor HCT, longer telomeres in donor white blood cells were associated with increased patient survival after transplantation, independent of donor age or other transplant-related factors. Telomeres are protective caps on the ends of our chromosomes that get shorter each time a cell divides.


Telomere length is a marker of cellular aging and has been implicated in the development of several cancers, as well as other age-related health conditions. The team’s findings suggest that incorporating telomere length with other HCT donor selection criteria may allow for refinements in donor selection to improve patient survival.


Gadalla SM, Wang T, Haagenson M, Spellman SR, Lee SJ, Williams KM, Wong JY, De Vivo I, Savage SA. (2015). Association between donor leukocyte telomere length and survival after unrelated allogeneic hematopoietic cell transplantation for severe aplastic anemia. JAMA. 313(6):594-602.