Representative cancer types enriched for the ALT pathway
| Cancer type | % ALT-positive (range)* | Known ALT-associated genes involved |
| Complex karyotype sarcomas | ||
| Leiomyosarcoma | 60 (52–78) | ATRX, DAXX |
| Osteosarcoma | 64 (49–86) | ATRX, DAXX, SLX4IP, SMARCAL1 |
| Liposarcoma | 27 (25–29) | ATRX |
| Undifferentiated sarcoma | 59 (36–77) | ATRX |
| Central nervous system tumours | ||
| IDH-mutant astrocytoma (WHO grade II) | 55 (27–100) | ATRX |
| IDH-mutant astrocytoma (WHO grade III) | 65 (21–92) | ATRX |
| IDH-mutant astrocytoma (WHO grade IV); adult | 16 (11–25) | ATRX, SMARCAL1 |
| IDH-mutant astrocytoma (WHO grade IV); paediatric | 39 (12–56) | ATRX, H3F3A |
| Other examples of specific cancer types | ||
| Pancreatic neuroendocrine tumours | 31 (21–61) | DAXX, ATRX |
| Neuroblastoma | 25 (18–47) | ATRX |
| Chromophobe hepatocellular carcinoma | 89 (87–92) | ATRX, SMARCAL1 |
*Adapted and updated from MacKenzie et al. 10
ALT, alternative lengthening of telomeres; IDH, isocitrate dehydrogenase.