Integrated clinical and molecular landscape of disseminated pediatric low-grade glioma

Many are indolent and have excellent outcomes, however a major cause of morbidity and mortality can occur when tumors spread throughout the CNS. To better understand this rare and difficult-to-treat entity, as well as the underlying processes driving dissemination in CNS tumors, we assembled a large international cohort (n=269) of patients with disseminated PLGG with detailed clinical and molecular characterization.

We identified three subgroups of patients based on the temporal and spatial distribution of dissemination. Tumors with diffuse leptomeningeal spread and those occurring in infants had the worst clinical outcomes. The genetics overlapped substantially with those in non-disseminated PLGG, suggesting that non-genetic mechanisms are an important contributor to dissemination.