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This attrition was absent in age-matched mutation carriers who did not have MDS/AML. We tested if adult short telomere patients without MDS/AML also had evidence of clonal hematopoiesis of indeterminate potential (CHIP)-related mutations and found 30% were affected. These patients also primarily suffered morbidity from pulmonary fibrosis during followup. Our data show the Mendelian short telomere syndromes are associated with a relatively narrow cancer spectrum, primarily MDS and AML. They suggest short telomere length is sufficient to drive premature age-r