Telomere length and associations with somatic mutations and clinical outcomes in acute myeloid leukemia

• Telomere length (TL) may be associated with clinical outcomes in AML.
• TL in AML appears to be associated with mutational class (i.e. activating vs. epigenetic mutations).
• IDH mutations are associated with longer TL.

We examined the genetic implications and clinical impact of telomere length (TL) in 67 patients with acute myeloid leukemia (AML). There was a trend toward improved survival at 6 months in patients with longer TL. We found that patients with activating mutations, such as FLT3-ITD, had shorter TL, while those with mutations in epigenetic modifying enzymes, particularly IDH1 and IDH2, had longer TL. These are intriguing findings that warrant further investigation in larger cohorts. Our data show the potential of TL as a predictive biomarker in AML and identify genetic subsets that may be particularly vulnerable to telomere-targeted therapies.