Short and complex-Telomeres and genomes in CLL

Chronic lymphocytic leukaemia (CLL) with complex karyotype (CK) represents a high-risk subgroup, often associated with refractory disease. In a patient cohort enriched for CK CLL, short telomeres were found to be associated with poor-risk characteristics such as unmutated immunoglobulin heavy chain variable region (IGHV), del(11q)/del(17p), CK/genomic complexity (GC) and chromothripsis. The presence of short telomeres was associated with shorter time to first treatment (TTFT) in the full cohort and in cases with CK or del(17p), and in multivariable analysis as a prognostic factor, indicating the potential importance of this biomarker for CLL risk stratification. Commentary on Ramos-Campoy et al. Exploring the synergy between telomere length and genomic complexity in CLL. Br J Haematol 2026; 208:1121-1126.