The identification of anaplastic lymphoma kinase (ALK) gene mutations in neuroblastic tumors

Neuroblastoma is the second most common tumor, following central nervous system tumors and is the cause of 7.2% of childhood cancer diagnosed before the age of 15. Neuroblastoma (NBL) is an embryonic tumor of the neuroectodermal cells that stem from neural crest and target sympathetic nervous system and adrenal medulla. Neuroblastoma is a tumor that shows a variety of clinical and biological characteristics along with a multitude of questions not answered yet. Due to the volatility of the tumor in its biological behaviors, neuroblastoma could show spontaneous regression, benign transformation or aggressive manner, which results in complications related to the prognosis and treatment of the disease.In recent years, the researches on Anaplastic lymphoma kinase gene mutation in neuroblastoma cases have been particularly focused on the familial model of neuroblastoma; and germ line mutations in ALK gene have been shown in such cases. It has been clearly presented that there is no sporadic ALK gene mutation in the 79 sporadic cases that represent the neuroblastoma population in Turkey. Not detecting mutations in ALK gene in these cases is of the utmost importance for the treatment model of neuroblastoma recommended in the literature. As known, the familial forms of neuroblastoma consist of only 1% of all the cases.Hence, for the neuroblastoma cases for which no affective treatment method has been found yet in the studies carried out, we do not think that prescribing target drugs pressing the kinase domain of the ALK gene production is an appropriate proposal for the sporadic cases in which neuroblastoma frequently occurs.In conclusion, it has been clearly presented that there is no sporadic ALK gene mutation in the 79 sporadic cases that represent the neuroblastoma population in Turkey. This situation shows the necessity to discuss ALK kinase domain proposed as the prognostic factor in the literature for neuroblastoma cases.