Telomeres, the ends of eukaryotic chromosomes, are structural and func
tional units composed of proteins and repetitive DNA sequences. Telome
res protect the ends of chromosomes from DNA loss caused by incomplete
replication of 3' ends. The obligatory loss of terminal sequence with
each cell division leads to telomere shortening, and is counteracted
in germline cells by an enzymatic activity termed telomerase that resy
nthesizes telomeric DNA de novo. Telomere length and telomerase activi
ty have been measured by several groups in both normal and malignant b
lood and marrow cells. Telomere length decreases with age in normal bl
ood and bone marrow, despite the presence of a detectable telomerase a
ctivity. In most hematologic malignancies telomere length is short and
telomerase activity is enhanced, compatible with the late activation
of the enzyme in tumour development. The implications of these finding
s for tumour pathogenesis, diagnosis, and treatment are discussed.