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Alternative lengthening of telomeres--an enhanced chromosomal instability in aggressive non-MYCN amplified and telomere elongated neuroblastomas.

Journal article
Authors Gisela Lundberg
Daniel Sehic
John-Kalle Länsberg
Ingrid Øra
Attila Frigyesi
Victoria Castel
Samuel Navarro
Marta Piqueras
Tommy Martinsson
Rosa Noguera
David Gisselsson
Published in Genes, chromosomes & cancer
Volume 50
Issue 4
Pages 250-62
ISSN 1098-2264
Publication year 2011
Published at Institute of Biomedicine, Department of Medical and Clinical Genetics
Pages 250-62
Language en
Keywords Adult, Anaphase, Cell Line, Tumor, Child, Child, Preschool, Chromosomal Instability, Female, Gene Amplification, Humans, In Situ Hybridization, Fluorescence, Infant, Infant, Newborn, Male, Neuroblastoma, genetics, pathology, Nuclear Proteins, genetics, Oncogene Proteins, genetics, Telomerase, metabolism, Telomere, genetics, Young Adult
Subject categories Medical Genetics


Telomere length alterations are known to cause genomic instability and influence clinical course in several tumor types, but have been little investigated in neuroblastoma (NB), one of the most common childhood tumors. In the present study, telomere-dependent chromosomal instability and telomere length were determined in six NB cell lines and fifty tumor biopsies. The alternative lengthening of telomeres (ALT) pathway was assayed by scoring ALT-associated promyelocytic leukemia (PML) bodies (APBs). We found a reduced probability of overall survival for tumors with increased telomere length compared to cases with reduced or unchanged telomere length. In non-MYCN amplified tumors, a reduced or unchanged telomere length was associated with 100% overall survival. Tumor cells with increased telomere length had an elevated frequency of APBs, consistent with activation of the ALT pathway. The vast majority of tumor biopsies and cell lines exhibited an elevated rate of anaphase bridges, suggesting telomere-dependent chromosomal instability. This was more pronounced in tumors with increased telomere length. In cell lines, there was a close correlation between lack of telomere-protective TTAGGG-repeats, anaphase bridging, and remodeling of oncogene sequences. Thus, telomere-dependent chromosomal instability is highly prevalent in NB, and may contribute to the complexity of genomic alterations as well as therapy resistance in the absence of MYCN amplification and in this tumor type.

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