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Long
survival and therapeutic responses in patients with histologically disparate
high-grade gliomas demonstrating chromosome 1p loss
Yasushi
Ino,
M.D., Magdalena
C. Zlatescu,
M.D., Hikaru
Sasaki,
M.D., Ph.D.,
David
R. Macdonald,
M.D., Anat
O. Stemmer-Rachamimov,
M.D., Sarah
Jhung,
B.S., David
A. Ramsay,
M.D., Andreas
Von Deimling,
M.D., David
N. Louis,
M.D., And
J. Gregory
Cairncross,
M.D.
Molecular
Neuro-Oncology Laboratory, Department of Pathology and Neurosurgical Service,
Massachusetts General Hospital and Harvard Medical School, Boston,
Massachusetts; Departments of Medical and Experimental Oncology and Pathology,
London Regional Cancer Centre and University of Western Ontario, London,
Ontario, Canada; and Department of Neuropathology, Charité, Humboldt
University, Berlin, Germany
Object.
Allelic loss of
chromosome 1p is a powerful predictor of tumor chemosensitivity and prolonged
survival in patients with anaplastic oligodendrogliomas.
Chromosome 1p loss also occurs in astrocytic and oligoastrocytic gliomas,
although less commonly than in pure oligodendroglial tumors.
This observation raises the possibility investigated in this study that
chromosome 1p loss might also provide prognostic information for patients with
highgrade gliomas with astrocytic components.
Methods.
The authors report
on seven patients with high-grade gliomas composed of either pure astrocytic or
mixed astrocytic–oligodendroglial phenotypes, who had remarkable
neuroradiological responses to therapy or unexpectedly long survivals.
All of the tumors from these seven patients demonstrated chromosome 1p loss,
whereas other genetic alterations characteristic of high-grade gliomas (p53 gene
mutations, EGFR gene amplification, chromosome 10 loss, chromosome 19q
loss, or CDKN2A/p16 deletions) were only found in occasional cases.
The authors also assessed the frequency of chromosome 1p loss in a series of
anonymous high-grade astrocytoma samples obtained from a tumor bank and
demonstrate that this genetic change is uncommon, occurring in only 10% of
cases.
Conclusions.
Although any
prognostic importance of chromosome 1p loss in astrocytic or mixed
astrocytic–oligodendroglial gliomas can only be determined in larger and
prospective series, these findings raise the possibility that some high-grade
gliomas with chromosome 1p loss, in addition to pure anaplastic
oligodendrogliomas, may follow a more favorable clinical course.
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