Unable to undergo MRI imaging. 12 SCREENING AND ON -STUDY TESTS AND PROCEDURES Progressive patients will be offered treatment options during this PRTBTC clinic visit. CMP and CBC with differential, and physical and neurologic examination with KPS score will be performed within 6 weeks prior to consent and may be taken from the previous standard of care Duke PRTBTC clinic visit. All subject data is standard of care eval uations that occur for all patients being seen in the PRTBTC , regardless of study entry . Screening examination must include pathology report from initial diagnosis to confirm IDH1 + WHO Grade II glioma diagnosis with MRI showing progressive lesion located i n resectable areas . Once consent is obtained, subjects will receive Td booster immunization I.M. Study-mandated leukapheresis is scheduled to occur followed by Td i.d. pre-conditioning scheduled 48 hours or less . Vaccine #1 is then given one day after Td pre- conditioning. Within 72 hours prior to undergoing the leukapheresis procedure , patients will have blood samples taken for the following tests as required by the Duke Apheresis Center: CBC w/diff, CMP, ionized Calcium, and β -HCG (for females of child- bearing potential). Total estimated blood volume required for these evaluations is 12- 15 mLs. For patients without sufficient venous access for leukapheresis, a temporary central intravenous catheter may be inserted. To prevent the development of hypocalcemi a from the citrate used for leukapheresis, all patients will be instructed to take oral Tums, 2 Pro00054746: RESIST Study Version: 20171011 PT-PhI-II v05.22.12 Duke Cancer Institute Page 29 CONFIDENTIAL tablets three times a day and at bedtime the day before and the day of the leukapheresis procedure. Patients who have lower levels of calcium will be treated per Apheresis lab standard protocols under the direction of apheresis attending physician. An aliquot of 107 PBMCs will be collected from this leukapheresis and sent to UNC Center for AIDS Research Virology, Immunology, & Microbiology Core Laboratory at 250 Bell Tower Drive, Genome Sciences Building, Room 2158, Chapel Hill, NC 27599 -7291. This blood sample will be sent to UNC for HLA assessment and ana lysis (please see Section 9.3 for rationale) . Subsequent vaccines will be given on day 15 ±3 days (vaccine #2) and day 29 ±3 days (vaccine #3) . Seven to 1 2 days after the 3rd vaccine, subjects will undergo surgical resection which is part of the SOC for these subjects . Patients with re- confirmed Grade II will be treated with adjuvant TMZ and vaccine. Patients that have transitioned to a higher Grade brain tumor will receive TMZ and radiation therapy per standard of care and monthly vaccines. For higher grade gliomas undergoing RT, vaccine #4 will be given during SOC clinic visit prior to initiating RT, and vaccine # 5 will be given 4 weeks later (± 1 week) during RT. Vaccine #6 will be given at the end of RT during the SOC clinic visit to review MRI and begin post -RT TMZ, if MRI stable. Then, subjects in this treatment group will receive vaccines monthly on day 2 2 (+2 days ) with post - RT cycles of TMZ to a maximum of 15 vaccines . If possible, t he provider will take a photo of the injection site at the pre- op appointment seven to twelve days after vaccine #3 to document the subject’s reaction to the vaccine. The provider may take additional pictures of the injection site at other clinic visits at the discretion of the treating physician or Principal Investigator . There will be no identifiers on the photographs. The photographs will be taken by the subject’s provider and may be uploaded to their electronic medical record or kept in a separate electronic or paper research file. The photographs will be uploaded to the electronic medical record by using electronic applications called Haiku for iPhones or Cantu for iPads. These applications allow for the photograph to be uploaded directly to the electronic medical record without the photographs being stored on the dev ice taking the picture. A ruler will be included in the photo to allow measurement of the size of the injection site reaction. To demonstrate quantitative repeatable measures of 2HG change in IDH1+ gliomas, patients will be scanned on the CAMRD MR scanner using a an MRS protocol. We will acquire MRS data at up to 5 time points: baseline (after consent and before PEP IDH1M vaccine #1) and up to 4 times prior to surgery (please refer to Section 9.5 for more detail) . IDH1 R132H biomarker component of the protocol and immune monitoring : a) Study of tumor -specific circulating nucleic acid from plasma of patients with gliomas with IDH1 R132H: We p lan to isolate circulating nucleic acids from the plasma of patients affected by glioma and attempt to detect tumor -specific circulating DNA containing the c.395G>A (R132H) mutation. We will follow the protocol as described by Boisselier, et al ., Neurology 201283 for plasma collection.