Abstract

Primary central nervous system malignant lymphoma (PCNSL) has been regarded as a rare neoplasm. Recently, however, its incidence has been rapidly increasing. Despite active clinical trials, its clinical and biologic features remain unknown and there has been no effective treatment or prognostic factor. The current study attempted to elucidate telomerase activity and expression of the telomere-related RNA of PCNSL as novel prognostic factors. The subjects were 12 patients with histologically diagnosed PCNSL. All patients were treated with chemoradiotherapy consisting of whole-brain radiation, vincristine, etoposide, and prednisolone. Telomerase activity in the resected tumor was analyzed both qualitatively and quantitatively using the TRAP (telomeric amplification assay protocol)/TRAP-HPA (hybridization protection assay) method. The expression of telomere-related RNA (hTERT, hTERC, and TEP1) was analyzed by reverse transcriptase-polymerase chain reaction. Telomerase activity was detected in 10 of 12 patients with PCNSL, with an average activity of 148.9 relative light units. The average telomere length was 5.55 kb. The expression of hTERT correlated with telomerase activity, and there was a statistically significant correlation between telomerase activity and both the duration of survival and the interval to tumor progression. Telomerase activity and the expression of hTERT may be novel prognostic factors in patients with PCNSL.

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