Article

Treatment-related myelodysplasia/AML in a patient with a history of breast cancer and an oligodendroglioma treated with temozolomide: case study and review of the literature.

Division of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, USA.
Neuro-Oncology (impact factor: 5.72). 08/2006; 8(3):280-3. DOI:10.1215/15228517-2006-003 pp.280-3
Source: PubMed

ABSTRACT The emergence of temozolomide as an effective alkylating agent with little acute toxicity or cumulative myelosuppression has led to protracted courses of chemotherapy for many patients with gliomas. Secondary, or treatment-related, myelodysplasia (t-MDS) and acute myelogenous leukemia (t-AML) are life-threatening complications of alkylating chemotherapy and have been reported in patients with primary brain tumors. We describe a case of temozolomide-related t-MDS/AML and discuss the clinical features of this condition. Administration of an alkylating agent in patient populations with long median survivals must be undertaken with an understanding of the potential for this treatment complication.

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    Nimit Singhal, Sudarshan Selva-Nayagam, Michael P Brown
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    ABSTRACT: Temozolomide is an alkylating agent used frequently in the management of gliomas. Although temozolomide is generally safe, rarely it can cause life threatening complications. Here we report the cases of two patients who developed prolonged and severe pancytopenia after low dose continuous temozolomide concurrently with cranial radiotherapy. The pancytopenia lasted two to six months. Both the patients were young, treatment naïve, and had temozolomide treatment for only approximately four weeks.
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Keywords

acute myelogenous leukemia
 
acute toxicity
 
alkylating agent
 
alkylating chemotherapy
 
chemotherapy
 
clinical features
 
cumulative myelosuppression
 
effective alkylating agent
 
myelodysplasia
 
primary brain tumors
 
protracted courses
 
Secondary
 
temozolomide
 
temozolomide-related t-MDS/AML
 
treatment complication