Late Anaplastic Gliomas in Children Previously Treated for Acute Lymphoblastic Leukemia

At least 33 cases of late anaplastic gliomas in children previously treated for acute lymphoblastic leukemia have been discussed in the literature including 20 well-documented cases. The frequency of this second malignancy is much greater than expected and may represent a 'new syndrome' with some genetic predisposition. Additionally, CNS prophylaxis which includes both radiation and intrathecal methotrexate appears to work synergistically in increasing the incidence of glial tumors especially multifocal tumors in these patients. The prognosis for these children is dismal but an aggressive treatment approach including surgery, interstitial radiation, and chemotherapy appears to improve survival.