Show simple item record

FieldValueLanguage
dc.contributor.authorBarbaro, Pasquale
dc.date.accessioned2019-10-01
dc.date.available2019-10-01
dc.date.issued2019-03-08
dc.identifier.urihttp://hdl.handle.net/2123/21162
dc.description.abstractTelomeres are specialised DNA structures that protect the ends of linear chromosomes, and their length is important for cell viability. Telomere length declines with age, and there is a large variability seen within the general population. Patients with short telomere disorders (STD) suffer increased toxicity from chemotherapy given for haematopoietic stem cell transplant (HSCT), however little is known of the relationship between telomere length, outcome and toxicity in the general population undergoing chemotherapy. This thesis shows that patients with STDs have poor short- and long-term outcomes following HSCT with mortality mostly due to pulmonary disease or infections. To define the relationship between telomere length and outcome in patients receiving therapy for cancer, we undertook retrospective analysis of outcome and telomere dynamics in children who had undergone HSCT, treatment for childhood acute lymphoblastic leukaemia (ALL) and who were long term survivors of childhood cancer. Children undergoing cancer treatment have an acute decline in telomere length at the time of cancer therapy, however there is no evidence that this telomere attrition continues in the long term, with the exception of patients with some cancer types, and who received certain specific chemotherapy agents. Patients undergoing HSCT or treatment for ALL with shorter telomere length have higher rates of specific organ toxicity and certain infections. However there does not appear to be any relationship between telomere length and significant late effects from childhood cancer, aside from avascular necrosis. These findings highlight the complex relationship between telomere length and cancer therapy. They require further confirmation in prospective clinical trials, and in a wider population with differing initial malignancies, and undergoing different chemotherapy regimes in order to better define the complex relationship between telomere length, chemotherapy and outcome.en_AU
dc.publisherUniversity of Sydneyen_AU
dc.publisherFaculty of Medicine and Healthen_AU
dc.publisherChildren's Medical Research Instituteen_AU
dc.rightsThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
dc.subjecttelomereen_AU
dc.subjectoncologyen_AU
dc.subjecttoxicityen_AU
dc.subjectpaediatricen_AU
dc.subjectcanceren_AU
dc.subjectoutcomeen_AU
dc.titleTelomere dynamics in children undergoing cancer treatment and the relationship between telomere length and treatment outcomeen_AU
dc.typePhD Doctorateen_AU
dc.type.pubtypeDoctor of Philosophy Ph.D.en_AU


Show simple item record

Associated file/s

Associated collections

Show simple item record

There are no previous versions of the item available.