Telomere maintenance by either telomerase activity or the recombination-mediated alternative lengthening of telomeres (ALT) mechanism is a hallmark of cancer. Tumors that use ALT as their telomere maintenance mechanism are characterized by long telomeres of great heterogeneity in length and by specific nuclear structures of co-localized promyelocytic leukemia protein and telomere DNA, called ALT-associated promyelocytic leukemia bodies (APBs). Recent advances have revealed a direct role for APBs in telomere recombination in ALT-positive cells. In this study, we investigated the possibility that APBs could occur before the long 'alternatively' lengthened telomeres arise, particularly in low-grade tumors. We measured APBs , telomere length , and telomerase activity in 64 astrocytomas inclusive of grade 1Ű4 tumors. Almost all grade 1Ű3 tumors (93%) were APBpositive using published criteria. Grade 2Ű3 APB-positive tumors also had long telomeres and were confirmed as ALT positive. However, grade 1 tumors lacked long telomeres and were therefore classified as ALT negative, but positive for telomere-associated promyelocytic leukemia bodies (TPB). This is the first report of a TPB-positive but ALT-negative tumor, and suggests that low-grade tumors have the foundation for recombinational telomere repair, as in ALT. Further work is warranted to characterize the TPB-positive phenotype in other early malignancies, as well as The proliferative life span of somatic cells is controlled by telomere length.1 Telomeres are repeatedly shortened with each cell division until the telomere is too short, and the cell ceases proliferation and goes into senescence.2,3 Acquisition of a telomere maintenance mechanism allows malignant cells to evade senescence and continue proliferation. 4 Known telomere maintenance mechanisms include telomerase 5 and the alternative lengthening of telomeres mechanism (ALT) that describes the elongation of telomeres by any telomeraseindependent mechanism.6 Tumors that use ALT are distinguished by their low, or lack of, detectable telomerase activity, 7 increased recombination at telomeres, 8 long and heterogeneous telomere length distributions by terminal restriction fragment (TRF) Southern blotting, 9 -13 and the presence of a specific type of aggregate that contains the promyelocytic leukemia (PML) protein and telomere DNA called ALT-associated PML bodies (APBs) in 5 to 10% of asynchronized dividing cells.14,15 The prevalence of the ALT telomere maintenance mechanism has been studied less extensively than telomerase, which is the predominant telomere maintenance mechanism used in over 85% of tumors collectively. 16 The estimated frequency of ALT tumors varies from 25 to 34% in grade 2ÏȘ4 astrocytomas, 35% in smooth muscle sarcomas, 47