High-grade spinal glioma (HGSG) is an uncommon but deadly tumor affecting children and adults. In children with diffuse midline glioma, the Histone H3 K27M mutation is linked to a poor prognosis. Due to the rarity of this mutation, inconsistent data, and the lack of multicenter studies on this topic, the function of H3 K27M mutation in the prognosis of adults with HGSG remains unknown. The researchers looked at a group of 30 adults with diffuse HGSG who had histological confirmation of diagnosis, surgical intervention, and treatment at six tertiary academic facilities between January 2000 and July 2020. The effect of the H3 K27M mutation on progression-free survival (PFS) and overall survival (OS) was the primary endpoint (OS).


The study included thirty patients (18 males and 12 females) with a median (range) age of 50.5 (19–76) years. There were no significant variations in outcomes based on tumor location, resection extent, gender, or the presence or absence of the H3 K27M mutation. Patients with H3 K27M mutation-positive tumors had a longer survival time (p = 0.017) when their HGSG had necrosis and microvascular proliferation (WHO grade IV histological characteristics). Although H3 K27M mutant–positive HGSG was linked to poor outcomes in adult patients, patients with H3 K27M–positive HGSG had slightly better results than their H3 K27M mutant–negative HGSG counterparts. More preclinical animal research and bigger clinical investigations are needed to understand the age-dependent implications of the H3 K27M mutation.