Genetic and epigenetic features of rapidly progressing IDH-mutant astrocytomas

Timothy E. Richardson, Adwait Amod Sathe, Mohammed Kanchwala, Gaoxiang Jia, Amyn A. Habib, Guanghua Xiao, Matija Snuderl, Chao Xing, Kimmo J. Hatanpaa

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


IDH-mutant astrocytomas are significantly less aggressive than their IDH-wildtype counterparts. We analyzed The Cancer Genome Atlas dataset (TCGA) and identified a small group of IDH-mutant, WHO grade II-III astrocytomas (n 14) with an unexpectedly poor prognosis characterized by a rapid progression to glioblastoma and death within 3 years of the initial diagnosis. Compared with IDH-mutant tumors with the typical, extended progression-free survival in a control group of age-similar patients, the tumors in the rapidly progressing group were characterized by a markedly increased level of overall copy number alterations ([CNA]; p 0.006). In contrast, the mutation load was similar, as was the methylation pattern, being consistent with IDH-mutant astrocytoma. Two of the gliomas (14%) in the rapidly progressing, IDH-mutant group but none of the other grade II-III gliomas in the TCGA (n 283) had pathogenic mutations in genes (FANCB and APC) associated with maintaining chromosomal stability. These results suggest that chromosomal instability can negate the beneficial effect of IDH mutations in WHO II-III astrocytomas. The mechanism of the increased CNA is unknown but in some cases appears to be due to mutations in genes with a role in chromosomal stability. Increased CNA could serve as a biomarker for tumors at risk for rapid progression.

Original languageEnglish (US)
Pages (from-to)542-548
Number of pages7
JournalJournal of neuropathology and experimental neurology
Issue number7
StatePublished - Jul 1 2018


  • Glioblastoma (GBM)
  • Isocitrate dehydrogenase
  • Prognosis
  • WHO 2016

ASJC Scopus subject areas

  • General Medicine


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