Clinical, Molecular Subgroups and Survival Rates Finding of Childhood Medulloblastoma: A Ten Years Moroccan Experience in Pediatric Hematology and Oncology Center.
Jaafari Mohamed1*, Nadia Cherradi2, Hafsa El ouazzani2, Sanae ouadghiri3,4, Alae Koraichi5, Razine Rachid6,7, Samia El hilali6,7 and Laila Hesseissen8

1Doctoral Study  Center for  Life and Health  Sciences, Faculty  of  Medicine  and  Pharmacy  of  Rabat, Impasse Souissi, Rabat 10100, Morocco

2Pathology Department of Specialties Hospital –University Hospital of Rabat - Faculty of Medicine and Pharmacy-Mohammed V University in Rabat, Morocco

3Blood Transfusion, Immunology and Cell Therapy Department, Ibn Sina University Hospital, Rabat, Morocco.

4Department of Education and Research in Immunology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco

5Department of Anesthesia and Intensive care in Children's Hospital of Rabat, Ibn Sina University Hospital, Rabat, Morocco.

6Laboratory of Biostatistics, Clinical, and Epidemiological Research, Department of Public Health, Faculty of Medicine and pharmacy-Mohamed V University in Rabat, Morocco.

7Laboratory of Community Health, Department of Public Health, Faculty of Medicine and Pharmacy Rabat, University Mohammed V, Rabat, Morocco.

8pediatric oncology and hematology department, Hopital d'enfant Rabat, Faculty of Medicine and pharmacy-Mohamed V University in Rabat, Morocco.

Corresponding Author E-mail: jaafarimohammed15@gmail.com

Abstract: Background: In Morocco, medulloblastoma (MB) is one of the most common malignant brain tumors in children. There is a deficiency of epidemiological information and typical characteristics of this pathology. Methods: In this retrospective study, we investigated 41 cases of MB diagnosed and treated at Rabat's University Hospital Ibn Sina from January 2010 until December 2019. Each patient underwent histological classification. Only 20 patients underwent molecular subgroups that were determined using immunohistochemistry (IHC) markers, including beta-catenin, GAB1, YAP1, and P53. Results: Histologically, there were only 3 instances with big cells or anaplastic types, 10 cases with nodular or desmoplasic cases, and 28 cases with classic types.. 6(30%) patients were in the nonWNT/nonSHH, 13(65%) patients and one patient(5%) were in SHH group and the WNT group respectively.  After five years, patients who had radiation therapy had the highest overall survival rates (P=0.035). There was a statistically significant P value for the interval between surgery and radiation therapy. Patients who began treatment within 120 days had the highest overall survival rates when compared to those who began treatment later (P=0.002). Patients with metastases also had the lowest survival rates, according to our findings (P=0.001) Conclusions: The study provides epidemiological data about the childhood MB from a single institution in Morocco. In terms of overall survival rates, the results are quite promising. However, there is still a need to reduce the large gap between high and low-income countries and improve survival outcomes. To achieve this, expanding the network of the oncology centers is recommended as well as implementing twinning and telemedicine initiatives.

Keywords: Childhood; Medulloblastoma; NonWNT/nonSHH; SHH; Survival rates; TP53; WNT

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