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Anaplastic oligodendroglioma

December 18, 2023

Anaplastic oligodendroglioma is a neuroepithelial tumor which is believed to originate from oligodendrocytes, a cell type of the glia. In the World Health Organization (WHO) classification of brain tumors, anaplastic oligodendrogliomas are classified as grade III.[2] In the course of the disease, it can degenerate into highly malignant oligodendroglioma, grade IV.[3] The vast majority of oligodendrogliomas occur sporadically, without a confirmed cause and without inheritance within a family.

Anaplastic oligodendroglioma
Video of tumor growth simulation (anaplastic oligodendroglioma). Simulation was run for 2600 days since tumor onset (one original cell) with a detection level of 1 cell/mm2.
SpecialtyNeuro-oncology
SymptomsEpilepsy-Seizures[1]
Usual onsetpeak years are age 45-50[1]
Durationuntil cure or death
CausesGenerally unknown[1]
Risk factorsGenerally unknown
Diagnostic methodBiopsy
Differential diagnosisOther gliomas
PreventionNot known
TreatmentSurgery, radiation, chemotherapy[1]
MedicationTemozolomide[1]
PrognosisGenerally fatal after 2-6 years[1]
Frequency0.07 to 0.18 per 100,000 person-years[1]

Signs edit

Pathogenesis edit

The (malignant) anaplastic oligodendroglioma belongs to the group of diffuse glioma and arises in the central nervous system (brain and spinal cord) from precursor stem cells of the oligodendrocytes. This tumor occurs primarily in middle adulthood with a frequency peak in the 4th and 5th decade of life.[3]

Diagnosis edit

The most important diagnostic procedure is magnetic resonance imaging (MRI). Occasionally, outside of routine diagnostics, the metabolism in the tissue is shown using positron emission tomography (PET). The diagnosis is confirmed by a fine tissue examination following an operation. Anaplastic oligodendrogliomas often show a loss of genetic material. About 50 to 70%[4] of WHO grade III anaplastic oligodendrogliomas have combined allele losses on the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q). This change is mostly referred to as "1p / 19q Co Deletion". It can be seen as favorable for the patient and makes a response to radiation or chemotherapy more likely. The designation of grade III oligodendroglioma (high grade) generally subsumes the previous diagnoses of anaplastic or malignant oligodendroglioma.[2]

  •  
    Histopathological image of anaplastic oligodendroglioma in cerebrum. Hematoxylin & eosin stain.
  •  
    Zooming, note the irregular cell- and nucleus-shapes.
  •  
    IDH1 R132H in anaplastic oligodendroglioma

Treatment edit

Surgery can help reduce symptoms caused by the tumor. As complete as possible removal of the tumor visible on the MRI is preferred, provided the location of the tumor allows this. Since typically the cells of an anaplastic oligodendroglioma have already migrated into the surrounding healthy brain tissue at the time of diagnosis, a complete surgical removal of all tumor cells is not possible. The "1p / 19q Codeletion" marker plays an increasingly important role in the selection of therapy and therapy combinations. Because this tumor is an "indolent condition" (a slowly progressive medical condition associated with little or no pain) and the potential morbidity associated with neurosurgery, chemotherapy and radiation therapy, most neuro-oncologists will initially pursue a course of watchful waiting and treat patients symptomatically. Symptomatic treatment often includes the use of anticonvulsants for seizures and steroids for brain swelling. For further treatment, radiation or chemotherapy with temozolomide or a chemotherapy with Procarbazine, CCNU and Vincristine (PCV) has been shown to be effective and was the most commonly used chemotherapy regimen used for treating anaplastic oligodendrogliomas.[3][5]

Prognosis edit

5–Year relative survival rate: Age 20–44, 76%. Age 45–54, 67%. Age 55–64, 45%.[6][7] Procarbazine, lomustine and vincristine have been used since May 1975. For 48 years, new therapeutic options have been regularly tested as part of therapy studies to improve the treatment of anaplastic oligodendroglioma.[8]

Research edit

As of 2022, a definitive cure is not possible with anaplastic oligodendrogliomas of WHO grade III. A retrospective study on 1054 patients with anaplastic oligodendroglioma, presented during the 2009 ASCO Annual Meeting, suggests that PCV therapy may be effective. Median time to progression for patients with 1p19q co-deletion was longer following PCV alone (7.6 years) than with temozolomide alone (3.3 years); median overall survival was also longer with PCV treatment versus temozolomide treatment (not reached, vs. 7.1 years).[9] A recent long-term study does affirm that radiation combined with adjuvant chemotherapy is significantly more efficacious for anaplastic oligodendroglioma patients with 1p 19q co-deleted tumors and has become the new standard of care.[10] It is possible that radiotherapy may prolong the overall time to progression for non-deleted tumors. If the tumor mass compresses adjacent brain structures, a neurosurgeon will typically remove as much of the tumor as he or she can without damaging other critical, healthy brain structures. Recent studies suggest that radiation does not improve overall survival (even when age, clinical data, histological grading, and type of surgery are considered).[11][12]

Literature edit

  • Weller M, van den Bent M, Preusser M, Le Rhun E, Tonn JC, Minniti G, Bendszus M, Balana C, Chinot O, Dirven L, French P, Hegi ME, A. S. Jakola, M. Platten, P. Roth, R. Rudà, S. Short, M. Smits, M. J. Taphoorn, A. von Deimling, M. Westphal, R. Soffietti, G. Reifenberger, W. Wick: EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. In: Nature reviews. Clinical oncology. Volume 18, Number 3, 03 2021, pp. 170-186, doi:10.1038/s41571-020-00447-z, PMID 33293629, PMC 7904519 (Review).

References edit

  1. ^ a b c d e f g Anderson, Mark D.; Gilbert, Mark R. (April 14, 2013). "Treatment Recommendations for Anaplastic Oligodendrogliomas That Are Codeleted". Oncology. 27 (4). Retrieved 4 January 2021.
  2. ^ a b Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (August 2007). "The 2007 WHO classification of tumours of the central nervous system". Acta Neuropathol. 114 (2): 97–109. doi:10.1007/s00401-007-0243-4. PMC 1929165. PMID 17618441.
  3. ^ a b c Radboud universitair medisch centrum. "highly malignant oligodendroglioma, grade IV" (PDF). www.radboudumc.nl/ (in Dutch). pp. 46–48.
  4. ^ administrador (5 February 2020). "Anaplastic oligodendroglioma, IDH-mutant & 1p/19q-codeleted".
  5. ^ Engelhard HH, Stelea A, Mundt A (November 2003). "Oligodendroglioma and anaplastic oligodendroglioma: clinical features, treatment, and prognosis". Surg Neurol. 60 (5): 443–56. doi:10.1016/s0090-3019(03)00167-8. PMID 14572971.
  6. ^ "Survival Rates for Selected Adult Brain and Spinal Cord Tumors". American Cancer Society. Retrieved 8 January 2021.
  7. ^ Ostrom, Quinn T.; Gittleman, Haley; Liao, Peter; Vecchione-Koval, Toni; Wolinsky, Yingli; Kruchko, Carol; Barnholtz-Sloan, Jill S. (October 2017). "CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014". Neuro-Oncology. 19 (S5): v1–v88. doi:10.1093/neuonc/nox158. PMID 29117289.
  8. ^ Gutin PH, Wilson CB, Kumar AR, Boldrey EB, Levin V, Powell M, Enot KJ (May 1975). "Phase II study of procarbazine, CCNU, and vincristine combination chemotherapy in the treatment of malignant brain tumors". Cancer. 35 (5): 1398–404. doi:10.1002/1097-0142(197505)35:5<1398::aid-cncr2820350524>3.0.co;2-c. PMID 1122488.
  9. ^ Lassman, A. B. (20 May 2009). "Retrospective analysis of outcomes among more than 1,000 patients with newly diagnosed anaplastic oligodendroglial tumors". Journal of Clinical Oncology. 27 (15S): 2014. doi:10.1200/jco.2009.27.15_suppl.2014. ISSN 0732-183X.
  10. ^ "New Standard of Care for Anaplastic Oligodendroglial Tumors with 1p/19q Codeletions – the ASCO Post".
  11. ^ Sunyach MP, Jouvet A, Perol D, et al. (December 2007). "Role of exclusive chemotherapy as first line treatment in oligodendroglioma". J. Neurooncol. 85 (3): 319–28. doi:10.1007/s11060-007-9422-3. PMID 17568995. S2CID 27456056.
  12. ^ Mohile NA, Forsyth P, Stewart D, et al. (September 2008). "A phase II study of intensified chemotherapy alone as initial treatment for newly diagnosed anaplastic oligodendroglioma: an interim analysis". J. Neurooncol. 89 (2): 187–93. doi:10.1007/s11060-008-9603-8. PMID 18458821. S2CID 30666549.

External links edit

December 18, 2023
anaplastic, oligodendroglioma, neuroepithelial, tumor, which, believed, originate, from, oligodendrocytes, cell, type, glia, world, health, organization, classification, brain, tumors, anaplastic, oligodendrogliomas, classified, grade, course, disease, degener. Anaplastic oligodendroglioma is a neuroepithelial tumor which is believed to originate from oligodendrocytes a cell type of the glia In the World Health Organization WHO classification of brain tumors anaplastic oligodendrogliomas are classified as grade III 2 In the course of the disease it can degenerate into highly malignant oligodendroglioma grade IV 3 The vast majority of oligodendrogliomas occur sporadically without a confirmed cause and without inheritance within a family Anaplastic oligodendroglioma source source source source source source Video of tumor growth simulation anaplastic oligodendroglioma Simulation was run for 2600 days since tumor onset one original cell with a detection level of 1 cell mm2 SpecialtyNeuro oncologySymptomsEpilepsy Seizures 1 Usual onsetpeak years are age 45 50 1 Durationuntil cure or deathCausesGenerally unknown 1 Risk factorsGenerally unknownDiagnostic methodBiopsyDifferential diagnosisOther gliomasPreventionNot knownTreatmentSurgery radiation chemotherapy 1 MedicationTemozolomide 1 PrognosisGenerally fatal after 2 6 years 1 Frequency0 07 to 0 18 per 100 000 person years 1 This article s factual accuracy may be compromised due to out of date information The reason given is Per the 2021 update of the WHO classification anaplastic oligodendroglioma is not a separate type of tumor Most are instead classified as the grade 3 subtype of oligodendroglioma IDH mutant and 1p 19q codeleted Please help update this article to reflect recent events or newly available information August 2021 Contents 1 Signs 2 Pathogenesis 3 Diagnosis 4 Treatment 5 Prognosis 6 Research 7 Literature 8 References 9 External linksSigns editThis section is empty You can help by adding to it October 2021 Pathogenesis editThe malignant anaplastic oligodendroglioma belongs to the group of diffuse glioma and arises in the central nervous system brain and spinal cord from precursor stem cells of the oligodendrocytes This tumor occurs primarily in middle adulthood with a frequency peak in the 4th and 5th decade of life 3 Diagnosis editThe most important diagnostic procedure is magnetic resonance imaging MRI Occasionally outside of routine diagnostics the metabolism in the tissue is shown using positron emission tomography PET The diagnosis is confirmed by a fine tissue examination following an operation Anaplastic oligodendrogliomas often show a loss of genetic material About 50 to 70 4 of WHO grade III anaplastic oligodendrogliomas have combined allele losses on the short arm of chromosome 1 1p and the long arm of chromosome 19 19q This change is mostly referred to as 1p 19q Co Deletion It can be seen as favorable for the patient and makes a response to radiation or chemotherapy more likely The designation of grade III oligodendroglioma high grade generally subsumes the previous diagnoses of anaplastic or malignant oligodendroglioma 2 nbsp Histopathological image of anaplastic oligodendroglioma in cerebrum Hematoxylin amp eosin stain nbsp Zooming note the irregular cell and nucleus shapes nbsp IDH1 R132H in anaplastic oligodendrogliomaTreatment editSurgery can help reduce symptoms caused by the tumor As complete as possible removal of the tumor visible on the MRI is preferred provided the location of the tumor allows this Since typically the cells of an anaplastic oligodendroglioma have already migrated into the surrounding healthy brain tissue at the time of diagnosis a complete surgical removal of all tumor cells is not possible The 1p 19q Codeletion marker plays an increasingly important role in the selection of therapy and therapy combinations Because this tumor is an indolent condition a slowly progressive medical condition associated with little or no pain and the potential morbidity associated with neurosurgery chemotherapy and radiation therapy most neuro oncologists will initially pursue a course of watchful waiting and treat patients symptomatically Symptomatic treatment often includes the use of anticonvulsants for seizures and steroids for brain swelling For further treatment radiation or chemotherapy with temozolomide or a chemotherapy with Procarbazine CCNU and Vincristine PCV has been shown to be effective and was the most commonly used chemotherapy regimen used for treating anaplastic oligodendrogliomas 3 5 Prognosis edit5 Year relative survival rate Age 20 44 76 Age 45 54 67 Age 55 64 45 6 7 Procarbazine lomustine and vincristine have been used since May 1975 For 48 years new therapeutic options have been regularly tested as part of therapy studies to improve the treatment of anaplastic oligodendroglioma 8 Research editAs of 2022 update a definitive cure is not possible with anaplastic oligodendrogliomas of WHO grade III A retrospective study on 1054 patients with anaplastic oligodendroglioma presented during the 2009 ASCO Annual Meeting suggests that PCV therapy may be effective Median time to progression for patients with 1p19q co deletion was longer following PCV alone 7 6 years than with temozolomide alone 3 3 years median overall survival was also longer with PCV treatment versus temozolomide treatment not reached vs 7 1 years 9 A recent long term study does affirm that radiation combined with adjuvant chemotherapy is significantly more efficacious for anaplastic oligodendroglioma patients with 1p 19q co deleted tumors and has become the new standard of care 10 It is possible that radiotherapy may prolong the overall time to progression for non deleted tumors If the tumor mass compresses adjacent brain structures a neurosurgeon will typically remove as much of the tumor as he or she can without damaging other critical healthy brain structures Recent studies suggest that radiation does not improve overall survival even when age clinical data histological grading and type of surgery are considered 11 12 Literature editWeller M van den Bent M Preusser M Le Rhun E Tonn JC Minniti G Bendszus M Balana C Chinot O Dirven L French P Hegi ME A S Jakola M Platten P Roth R Ruda S Short M Smits M J Taphoorn A von Deimling M Westphal R Soffietti G Reifenberger W Wick EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood In Nature reviews Clinical oncology Volume 18 Number 3 03 2021 pp 170 186 doi 10 1038 s41571 020 00447 z PMID 33293629 PMC 7904519 Review References edit a b c d e f g Anderson Mark D Gilbert Mark R April 14 2013 Treatment Recommendations for Anaplastic Oligodendrogliomas That Are Codeleted Oncology 27 4 Retrieved 4 January 2021 a b Louis DN Ohgaki H Wiestler OD Cavenee WK Burger PC Jouvet A Scheithauer BW Kleihues P August 2007 The 2007 WHO classification of tumours of the central nervous system Acta Neuropathol 114 2 97 109 doi 10 1007 s00401 007 0243 4 PMC 1929165 PMID 17618441 a b c Radboud universitair medisch centrum highly malignant oligodendroglioma grade IV PDF www radboudumc nl in Dutch pp 46 48 administrador 5 February 2020 Anaplastic oligodendroglioma IDH mutant amp 1p 19q codeleted Engelhard HH Stelea A Mundt A November 2003 Oligodendroglioma and anaplastic oligodendroglioma clinical features treatment and prognosis Surg Neurol 60 5 443 56 doi 10 1016 s0090 3019 03 00167 8 PMID 14572971 Survival Rates for Selected Adult Brain and Spinal Cord Tumors American Cancer Society Retrieved 8 January 2021 Ostrom Quinn T Gittleman Haley Liao Peter Vecchione Koval Toni Wolinsky Yingli Kruchko Carol Barnholtz Sloan Jill S October 2017 CBTRUS Statistical Report Primary brain and other central nervous system tumors diagnosed in the United States in 2010 2014 Neuro Oncology 19 S5 v1 v88 doi 10 1093 neuonc nox158 PMID 29117289 Gutin PH Wilson CB Kumar AR Boldrey EB Levin V Powell M Enot KJ May 1975 Phase II study of procarbazine CCNU and vincristine combination chemotherapy in the treatment of malignant brain tumors Cancer 35 5 1398 404 doi 10 1002 1097 0142 197505 35 5 lt 1398 aid cncr2820350524 gt 3 0 co 2 c PMID 1122488 Lassman A B 20 May 2009 Retrospective analysis of outcomes among more than 1 000 patients with newly diagnosed anaplastic oligodendroglial tumors Journal of Clinical Oncology 27 15S 2014 doi 10 1200 jco 2009 27 15 suppl 2014 ISSN 0732 183X New Standard of Care for Anaplastic Oligodendroglial Tumors with 1p 19q Codeletions the ASCO Post Sunyach MP Jouvet A Perol D et al December 2007 Role of exclusive chemotherapy as first line treatment in oligodendroglioma J Neurooncol 85 3 319 28 doi 10 1007 s11060 007 9422 3 PMID 17568995 S2CID 27456056 Mohile NA Forsyth P Stewart D et al September 2008 A phase II study of intensified chemotherapy alone as initial treatment for newly diagnosed anaplastic oligodendroglioma an interim analysis J Neurooncol 89 2 187 93 doi 10 1007 s11060 008 9603 8 PMID 18458821 S2CID 30666549 External links edit Molekulare Diagnostik Center for Neuropathology and Prion Research Ludwig Maximilian University of Munich Retrieved 2021 10 23 Retrieved from https en wikipedia org w index php title Anaplastic oligodendroglioma amp oldid 1190534619, wikipedia, wiki, book, books, library,

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