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Previous studies have reported that telomere length in peripheral blood leukocytes (PBLs) can predict the clinical outcome of several cancers.However, whether leukocyte telomere length is associated with the prognosis of hepatocellular carcinoma (HCC)remains to be determined.In this study, relative telomere length (RTL) in PBLs was measured using a real-time PCR-based method for 269 HCC patients treated with transarterial chemoembolisation (TACE) from two independent hospitals.The association between RTL and the overall survival of HCC was analyzed.The immunological function of the HCC patients with different leukocyte RTLs was evaluated.Multivariate analyses indicated that long leukocyte RTL was significantly associated with poor overall survival of HCC patients, with an hazard ratio (HR) of 2.04 (95% confidence interval,1.46-2.86;P < 0.001).Kaplan-Meier analyses showed a significant difference of median survival time (MST) between patients with long and short RTL (log rank P < 0.001).FACS analyses showed that the long RTL group had a significantly increased percentage of CD4+CD25+FOXP3+ Treg in CD4+ T cells, compared to short RTL group (P =0.002).In conclusion, our results suggest that leukocyte RTL may serve as an independent prognostic marker for HCC patients treated with TACE.