Telomeres and their maintenance by telomerase have been implicated to play an important role in carcinogenesis. As almost all malignant tumors express telomerase (in contrast to normal somatic cells), assessment of its activity has been proposed as a diagnostic and prognostic tool. To test the prognostic value of telomerase in pediatric soft tissue sarcoma (STS), we analyzed telomere length (by telomere restriction fragment analysis), telomerase activity (by modified telomerase repeat amplification protocol assay), and expression of human telomerase reverse transcriptase (hTERT) mRNA (by TaqMan technique) in cell lines of different types of STS from 12 children and adolescents. Telomere length (3.7-9.0 kb) showed a very heterogeneous pattern, independent of subtype of STS or the age of the patients, and it was not associated with expression of hTERT mRNA. In contrast, there was a trend of an association between hTERT and telomerase activity. The three tested cell lines of embryonal rhabdomyosarcomas demonstrated no or low (n ϭ 2) telomerase activity, which was confirmed in two cases by a very low expression of hTERT mRNA. Thus, we suggest that the significant difference (p Ͻ 0.01) in the less aggressive clinical behavior of embryonal rhabdomyosarcomas in comparison to other subtypes may be due to differences in telomerase expression. Taken together, our cell line experiments imply that telomerase activity might be a biologic marker for stratification between STS with different clinical prognosis. Abbreviations TRF, telomere restriction fragment TRAP, telomerase repeat amplification protocol STS, soft tissue sarcoma hTERT, human telomerase reverse transcriptase RME, embryonal rhabdomyosarcoma RMA, alveolar rhabdomyosarcoma PNET, peripheral neuroectodermal tumor RT, rhabdoid tumorThere is now increasing evidence that maintenance of telomeres plays an important role during cellular aging and carcinogenesis (1, 2). Telomeres represent the end of chromosomes and consist of repetitive nucleotide units with the sequence (TTAGGG) n . They serve to protect linear chromosomes from damage and provide the structural basis for solving the socalled "end replication problem" (3, 4). With each cell division, telomeres show a progressive loss of their length, and at a critical limit normally cells stop dividing and enter senescence (1, 4). Such critical shortening can be prevented by the multisubunit enzyme telomerase comprised of a RNA template component (hTR), the catalytic reverse transcriptase component (hTERT), and regulatory proteins (5). The ribonucleoprotein telomerase adds additional TTAGGG repeats at the ends of telomeres and its activity is down-regulated in most postembryonic cell types (6). However, in most cancer cells telomerase expression is activated, and this can lead to cellular immortalization. Thus, acquisition of telomerase activity is a crucial step in restoring the replicative potential of cells and in initiating human cell transformation (7).Therefore, telomerase has been a focus in cancer research, espe...