Abstract
Introduction: High-grade glioma (HGG) constitutes about 15% of all pediatric brain tumors. These tumors are very aggressive, resulting in a poor prognosis. Survival rates of pediatric high-grade gliomas (pHGG) range from 15 to 35%. Within this group, 10-12% tumors occur in children less than five years old. This subgroup is called infantile high-grade glioma(iHG). This group has a better prognosis, and survival rates are around 60 to 70%. This is the very first study conducted on the management of iHG done at a public sector hospital in our country. The objective of the study is to share a single-center experience on the management of iHG in a resource-limited setting in a low-middle-income country(LMIC).
Methodology: Compiled data of cases of iHG in a retrospective manner diagnosed between 2021-2024 at the Pediatric Hematology Oncology department of The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan. All five patients, after surgical resection and histopathologic confirmation, without molecular correlation, were treated according to the Baby POG protocol.
Results: The most common presenting symptoms were hemiparesis (80%). Median duration of symptoms was 1.5 months (1-6months). Median age at presentation was 2.5years (1-3 years). Male predominance with a male-to-female ratio of 3:2. The most common site of occurrence was the cerebral hemisphere (80%), with predominance in the parietal lobe (60%). One case of midline iHG was reported. The overall survival rate (OS) was 80%. Only one patient expired due to the progression of the primary tumor.
Conclusion: Despite a limited-resource setting in LMIC, iHG treated with surgical resection and adjuvant chemotherapy demonstrated a similar outcome to that reported in the literature, and infants tolerated chemotherapy well. Regarding the diagnosis of iHG in resource-limited settings with a lack of molecular analysis facility, basic morphology and immunohistochemistry can be reliably used.
Competing Interests: None
Funding: None
Disclosure statement: None
License: This article is published under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0).
©️ Sana Gull, 2025. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.