Session Title: AA 2021 Virtual Posters - General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Christopher W. Lewis, MD: No financial relationships or conflicts of interest
Objective: Glioblastoma multiforme (GBM) is graded using molecular markers, including isocitrate dehydrogenase (IDH) mutation and methylguanine-DNA methyltransferase (MGMT) promoter methylation, which guide cancer therapy. However, the relationship between these markers and functional status changes during inpatient rehabilitation (IPR) is unknown. Our objective was to determine the incidence of these markers among GBM patients undergoing IPR, and examine their association to change in functional independence measure (FIM).
Design: Retrospective cohort study.Setting : Freestanding inpatient rehabilitation facility (IRF).Participants : 50 GBM patients with biopsy-proven IDH mutation status (wild-type vs mutant) and MGMT promoter methylation status (methylated vs unmethylated) were admitted to IPR between March 2017 and August 2018.
Interventions: Not applicable.
Main Outcome Measures: Change in FIM from IPR admission to discharge.
Results: Of 50 patients with GBM, 36% were MGMT-methylated and 94% were IDH-wildtype. Median age on admission was 61 (range 22-83) and length of stay was 17.5 days (range 1-90). 58% of patients were female. Mean motor FIM gain in the total population was 12.5 (SD 11.0), mean cognitive FIM gain was 1.5 (SD 4.7), and mean total FIM gain was 14.6 (SD 13.3). Stratification of motor, cognitive, and total FIM gain by MGMT methylation status found no significant differences. Patients with IDH-wildtype GBM had lower mean total FIM gains (mean 13.4, SD 12.4) than patients with IDH-mutant GBM (mean 33.0, SD 17.3, p=0.01). Mean motor FIM gains were also lower among patients with IDH-wildtype GBM (mean 11.6, SD 10.2) than IDH-mutant GBM (mean 27, SD 15.1, p=0.01). No significant difference in cognitive FIM gains was identified between IDH-wildtype (mean 1.9, SD 4.7) and IDH-mutant populations (mean 6.0, SD 3.6, p=0.14).Conclusions: The presence of certain molecular markers of GBM was associated with changes in FIM at discharge from the IRF. Though low in incidence, IDH-mutant GBM status was associated with greater functional gains. The exact mechanism requires further delineation.
Level of Evidence: Level IV
To cite this abstract in AMA style:Lewis CW, Jayabalan P, Roy I. The Relationship Between Glioblastoma IDH Mutation and MGMT Methylation Status and Functional Gains During Inpatient Rehabilitation [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-relationship-between-glioblastoma-idh-mutation-and-mgmt-methylation-status-and-functional-gains-during-inpatient-rehabilitation/. Accessed September 28, 2023.
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