Abstract Aim To examine the profile of children with high grade gliomas seen in our hospital and the management and outcome over the past years. Method The data were obtained from an existing database within the paediatic hematology and oncology division. The period covered is from 2010 to 2025. Demographics, clinical history and presentation, imaging , histology when applicable and treatment were obtained . Results Thirty children were seen. Age at diagnosis ranged from 0 year to 16 years with median age of 8.5 . Thirteen were female and seventeen were male. The duration from onset of symptoms to diagnosis ranged from one day to four months. All patients had MRI brain and spine. Locations of the tumors are as follows: thalamus/I (4), frontal lobe (2), ventricle (1), brainstem ( 16), cerebellum (2), spine (1), temporal lobe (2), and pineal gland (1). Twenty two had surgery ( biopsy , resection). Histologies were high grade glioma, anaplastic astrocytoma and anaplastic ependymoma. Sixteen children had tumor in the brainstem of whom ten had biopsies. They were all diagnosed from year 2016 onwards. In the histologies of midline gliomas, eleven had mutation in H3K27M gene. Additional gene sequencing to look for molecular targets were performed. We identified mutations for some in the following genes: p53, PIK3Ca and PDGFR. Prior to 2026, most patients had standard treatments of surgery, radiation and chemotherapy ( most common being temozolomide and CCNU. Following 2016, patients received bevacizumab and irinotecan, ONC (4), nimotuzumab (1), everolimus with riboclicib ( 1). Palliative care involvement in recent years started at diagnosis. In select cases, involvement of child life and palliative care services resulted in creating meaningful moments for the children. Amongst parents of children with diffuse midline gliomas, those diagnosed during the more recent years were more likely to be proactive in search of ongoing clinical trials. They are more likely to look for newer drugs to try. Seven children were lost to follow up. In twenty three children, survival ranged from 4 weeks to 4 years. Two with brainstem lesions are longterm survivors. Both were diagnosed in infancy, but only one had biopsy performed to confirm the diagnosis of high grade glioma. Both did not receive any treatment. Conclusion More children are likely to undergo treatment due to increased information from clinical trials and use of gene sequencing. Coordinated care from a multidisciplinary team has evolved over the years.
Kimpo et al. (Tue,) studied this question.