Regular Article

British Journal of Cancer (2001) 85, 831–835. doi:10.1054/bjoc.2001.2008 www.bjcancer.com
Published online 11 September 2001

Detection of the PAX3-FKHR fusion gene in paediatric rhabdomyosarcoma: a reproducible predictor of outcome?

J Anderson1,*, T Gordon1,2, A McManus1,2, T Mapp3, S Gould5, A Kelsey6, H McDowell4, R Pinkerton1, J Shipley2 and K Pritchard-Jones1 (on behalf of the UK Children's Cancer Study Group (UKCCSG) and the UK Cancer Cytogenetics Group)1

  1. 1Section of Paediatric Oncology, Section of Molecular Carcinogenesis, Institute of Cancer Research, Sutton, Surrey, UK
  2. 2Section of Molecular Cytogenetics Team, Section of Molecular Carcinogenesis, Institute of Cancer Research, Sutton, Surrey, UK
  3. 3United Kingdom Children's Cancer Study Group, Leicester, UK
  4. 4Alder Hey Children's Hospital, Liverpool, UK
  5. 5John Radcliffe Hospital, Oxford, UK
  6. 6Manchester Children's Hospital, Manchester, UK

*Current address: Unit of Molecular Haematology and Oncology, Institute of Child Health, Guilford Street, London WC1N 1EH, UK.

Received 20 November 2000; Revised 29 May 2001; Accepted 3 July 2001.

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Abstract

Rhabdomyosarcoma has 2 major histological subtypes, embryonal and alveolar. Alveolar histology is associated with the fusion genes PAX3-FKHR and PAX7-FKHR. Definition of alveolar has been complicated by changes in terminology and subjectivity. It is currently unclear whether adverse clinical behaviour is better predicted by the presence of these fusion genes or by alveolar histology. We have determined the presence of the PAX3/7-FKHR fusion genes in 91 primary rhabdomyosarcoma tumours using a combination of classical cytogenetics, FISH and RT-PCR, with a view to determining the clinical characteristics of tumours with and without the characteristic translocations. There were 37 patients with t(2;13)/PAX3-FKHR, 8 with t(1;13) PAX7-FKHR and 46 with neither translocation. One or other of the characteristic translocations was found in 31/38 (82%) of alveolar cases. Univariate survival analysis revealed the presence of the translocation t(2;13)/PAX3-FKHR to be an adverse prognostic factor. With the difficulties in morphological diagnosis of alveolar rhabdomyosarcoma on increasingly used small needle biopsy specimens, these data suggest that molecular analysis for PAX3-FKHR will be a clinically useful tool in treatment stratification in the future. This hypothesis requires testing in a prospective study. Variant t(1;13)/PAX7-FKHR appears biologically different, occurring in younger patients with more localised disease. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords:

rhabdomyosarcoma, prognosis, translocation

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