title: Telomere length is a prognostic factor in neuroblastoma.
abstract: BACKGROUND
  Maintenance of telomeres, in most instances by reactivation of telomerase, is obligatory for the indefinite proliferation of tumor cells. The objective of this study was to evaluate telomere length and telomerase activity (TA) as markers for progression and prognosis in neuroblastoma.
  
  
  METHODS
  Primary tumor samples from 51 patients were analyzed for telomere length and TA and were correlated with known prognostic parameters and outcome.
  
  
  RESULTS
  Telomere length had a highly significant correlation with prognosis (P = .007). Short telomeres were predictive of a favorable prognosis, whereas long or unchanged telomeres were predictive of a poor outcome. For the first time to their knowledge, the authors have shown that, within the high-risk group patients, telomere length could define a favorable subgroup that had a progression-free survival (PFS) rate of 86% compared with a PFS rate of 36% for patients with more adverse disease, which is the expected PFS rate for such patients (P = .04). In a multivariate analysis, telomere length was the most significant prognostic parameter (P = .032). TA was correlated significantly with outcome and with known prognostic factors. High TA and low TA were associated with adverse and favorable outcomes, respectively (P = .01).
  
  
  CONCLUSIONS
  The results of this investigation suggested that telomere length is a highly significant prognostic parameter of clinical relevance in patients with neuroblastoma. In high-risk patients, telomere length was the sole significant parameter that identified a group of patients who had a favorable prognosis. The authors suggest that telomere length should be included in the recommended diagnostic investigations for patients with neuroblastoma.
authors.affiliation: Molecular Oncology Laboratory, Felsenstein Medical Research Center, Rabin Medical Campus, Petah Tikva, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Ohali
authors.forename: Smadar
authors.initials: S
authors.lastname: Avigad
authors.forename: Shifra
authors.initials: S
authors.lastname: Ash
authors.forename: Yacov
authors.initials: Y
authors.lastname: Goshen
authors.forename: Drorit
authors.initials: D
authors.lastname: Luria
authors.forename: Meora
authors.initials: M
authors.lastname: Feinmesser
authors.forename: Rina
authors.initials: R
authors.lastname: Zaizov
authors.forename: Isaac
authors.initials: I
authors.lastname: Yaniv
mesh_terms: D015139:Blotting, Southern; D002648:Child; D002675:Child, Preschool; D004273:DNA, Neoplasm / Q000032:analysis / Q000235:genetics; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000235:genetics / Q000473:pathology*; D011379:Prognosis; D016019:Survival Analysis; D016615:Telomere / Q000235:genetics*
chemical_list: D004273:DNA, Neoplasm