Myelodysplastic syndrome-post cytotoxic therapy for pediatric low-grade glioma

Childs Nerv Syst. 2025 May 29;41(1):192. doi: 10.1007/s00381-025-06855-9.

Abstract

Myeloid neoplasms-post cytotoxic therapy (MN-pCT, previously therapy-related myeloid neoplasms/tMN), are secondary malignancies associated with prior chemotherapy treatment, historically carrying a very poor prognosis. These are rarely associated with primary central nervous system (CNS) tumors, usually high-grade CNS malignancies requiring intensive multimodal treatment. Pediatric low-grade gliomas (pLGGs) are the most common childhood CNS tumors, and up to 50% of patients will require adjuvant therapy, which has traditionally consisted of low-dose metronomic chemotherapy, though the recent identification of key molecular drivers of pLGG means targeted therapies are changing this paradigm. We present a novel case of a 17-year-old girl with therapy-related myelodysplastic syndrome following chemotherapeutic treatment for pLGG. Given the poor prognosis of MN-pCTs, this case represents an important note of caution when choosing appropriate therapy for pLGG, especially considering the evolving role for targeted treatments in this disease.

Keywords: Myeloid neoplasm-post cytotoxic therapy; Pediatric low-grade glioma.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / therapeutic use
  • Brain Neoplasms* / drug therapy
  • Female
  • Glioma* / diagnostic imaging
  • Glioma* / drug therapy
  • Humans
  • Myelodysplastic Syndromes* / chemically induced
  • Myelodysplastic Syndromes* / diagnostic imaging

Substances

  • Antineoplastic Agents