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About Childhood Anaplastic Astrocytoma

  • Anaplastic astrocytoma is a brain tumor that arises from brain cells called astrocytes, a type of glial cell. It is both a type of astrocytoma and high-grade glioma.

    • Anaplastic astrocytoma and glioblastoma multiforme (GBM) are high-grade gliomas and account for approximately ten percent of pediatric brain tumors.
    • Anaplastic astrocytoma occurs with increased frequency in families with neurofibromatosis type I, Li-Fraumeni syndrome, hereditary nonpolyposis colon cancer, and tuberous sclerosis.
    • Sixty-five percent of anaplastic astrocytoma tumors arise in the cerebral hemispheres, the top part of the brain.
    • Twenty percent of anaplastic astrocytoma tumors occur in the thalamus and hypothalamus or the diencephalon, the area responsible for identifying sensations such as temperature, pain and touch, regulation of appetite, weight, and body temperature, as well as connecting the brainstem to the cortex.
    • Fifteen percent of anaplastic astrocytoma tumors can appear in the cerebellum and brain stem region known as the posterior fossa.
    • The median age at diagnosis of anaplastic astrocytoma is nine to ten years old.

    At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, our Childhood Glioma Program is one of the world’s most extensive pediatric glioma treatment programs. We bring together leading pediatric brain tumor specialists to provide children with anaplastic astrocytoma the most advanced, effective care.

    Causes of Childhood Anaplastic Astrocytoma

    Most anaplastic astrocytomas and high-grade gliomas occur sporadically or without an identifiable cause. They do, however, occur with increased frequency in families with the following conditions.

    • Neurofibromatosis type I
    • Li-Fraumeni syndrome
    • Hereditary nonpolyposis colon cancer
    • Tuberous sclerosis

    Anaplastic astrocytomas are also associated with exposure to vinyl chloride and high doses of radiation therapy to the brain.

    Symptoms of Childhood Anaplastic Astrocytoma

    Each child’s symptoms will vary depending on the tumor’s size and location, and related inflammation. Symptoms may appear slowly and subtly or quickly and aggressively. If you witness any unusual symptoms, prompt medical attention is critical.

    Common symptoms include:

    • Headache (generally upon awakening in the morning)
    • Lethargy
    • Vomiting
    • Seizures
    • Weakness and other motor dysfunction neuroendocrine abnormalities
    • Changes in behavior or thought processes

    How We Diagnose Childhood Anaplastic Astrocytoma

    Diagnosis starts with a thorough review of your child’s medical history and assessments of their physical and neurological health. Your doctor will also order a combination of diagnostic tests including imaging studies and a biopsy.

    After we complete all tests and review the results, we will discuss the most effective treatment plan for your child.

    How We Treat Childhood Anaplastic Astrocytoma

    The first line of treatment for anaplastic astrocytoma is surgery to remove as much of the tumor as possible. We follow up surgery with radiation treatment to eliminate remaining cancer cells. Chemotherapy is generally unsuccessful for this type of tumor.

    Treatment may include:

    • Surgery: We use advanced neurosurgical techniques to remove tumors in this delicate area, such as interoperative MRI where a surgeon can visualize the tumor as they operate. While we always try to take out as much of the tumor as possible, most anaplastic astrocytoma tumors can’t be removed entirely because they tend to intrude on or near healthy tissue. Outcomes generally improve when the tumor is more completely removed.
    • Radiation therapy: We use radiation after surgery to increase treatment effectiveness. Radiation uses high-energy waves from a specialized machine to damage or shrink tumors.

    The prognosis for children with anaplastic astrocytoma is challenging. Our Pediatric Advanced Care Team (PACT) offers additional supportive treatments that help children’s quality of life and promote comfort and healing.

    Beyond PACT, the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic provides access to same-day follow-up visits with your child’s care team and access to support specialists including neuropsychologists.

    Research and Clinical Trials for Childhood Anaplastic Astrocytoma

    Clinical trials provide new options for children with brain tumors. Dana-Farber/Boston Children’s scientists are conducting numerous research studies to help clinicians better understand and treat malignant gliomas including anaplastic astrocytoma.

    Learn more about our clinical trials. If you have questions about clinical trials, your child’s doctor can help you navigate the process.

    Long-term Outcomes for Children with Anaplastic Astrocytoma

    Unfortunately, the prognosis for anaplastic astrocytoma remains poor. When surgery can remove the tumor almost entirely, the chance of survival is greater. Your child’s doctor will discuss treatment options with you, including clinical trials and supportive care.

    For children with relapsed anaplastic astrocytoma, we offer access to the latest clinical trials and experimental therapies. Current trials include novel medications, as well as new methods for the delivery of more traditional agents.

    Childhood Anaplastic Astrocytoma Treatment Team

    Our comprehensive team of pediatric cancer specialists includes the world’s leading clinicians and excellent support staff. See a complete list of the specialists in our Childhood Brain Tumor Center.