Good response of glioblastoma in a child with sickle cell anemia supports the therapeutic potential of tumor infarcting agents

A number of anti-angiogenesis and thrombosing agents are in development for the treatment of a range of cancer types. However, there are few clinical data to support this approach. We reviewed our experience with a child with sickle cell anemia and glioblastoma multiforme to look at a possible contribution of sickling and therefore vascular infarction on tumor control. A 3 1/2-year-old girl with sickle cell anemia, developed a cerebral glioblastoma multiforme. She received 5 cycles of ifosfamide and etoposide as well as 54 Gy local irradiation. Follow-up was monitored with serial MR scans. Four and a half years from diagnosis the child is neurologically normal and has no radiographic evidence of tumor. While we cannot say whether this child did well by chance alone, we hypothesize that local sickling with resultant tumor infarction may have been a factor in her unexpectedly good outcome. Her course lends anecdotal support to the notion that small vessel infarction can play a therapeutic role in the management of solid tumors.